Secretion of activin A in recurrent epithelial ovarian carcinoma

Objectives. Activin A is a dimeric protein, composed of two beta-A subunits , that belongs to the TGF-beta family of growth factors, Most primary epith elial ovarian tumors (96%) synthesize and secrete activin protein in vitro and preliminary studies show that serum levels of activin are frequently el evated in women with epithelial ovarian cancer. Our objectives were to expa nd on studies of serum activin A levels in women with epithelial ovarian ca ncer and to determine whether levels of activin A correlate with the clinic al course of disease. Method. Preoperative serum activin A levels were measured in 41 patients wi th epithelial ovarian cancer. In addition, serum activin A levels were meas ured in all available postoperative samples from the subset of these patien ts (n = 26) who had an elevated preoperative serum activin A level. Medical record information was used to compare each patient's serum levels of acti vin A to the clinical course of disease. Results. Seventy-two percent of the stage III and IV patients (26/36), and none (0/5) of the stage I patients, had an elevated preoperative serum acti vin level, In postoperative samples, activin A levels were increased with p ersistent or recurrent (n = 9) stage LII or IV ovarian cancer. Activin A le vels dropped postoperatively and remained at or below the control level in patients in remission. Conclusion. Serum activin A levels correlate with recurrent or persistent d isease in patients with epithelial ovarian cancer. (C) 1999 Academic Press.