Type I and type III collagen metabolites as predictors of clinical outcomein epithelial ovarian cancer

We evaluated the significance of biochemical tumor markers, ie, aminotermin al propeptide of type III procollagen, trivalently cross-linked COOH-termin al telopeptide of type I collagen (ICTP), aminoterminal propeptide of type I procollagen, and CA 125 in the prediction of ovarian cancer outcome and c ompared them with several classical indicators of prognosis. The concentrat ions of biochemical markers were determined from the preoperative serum spe cimens of 55 patients with epithelial ovarian cancer. In the univariate ana lysis, all biochemical markers except PINP and all conventional prognostic indicators except histological subtype correlated significantly with surviv al. In the multivariate Cox analysis of biochemical markers, serum ICTP rem ained the only significant prognostic indicator of overall survival, Among all variables, clinical stage and ICTP were the only independent and signif icant determinants of prognosis. Because the content of trivalently cross-l inked, mature type I collagen (the breakdown of which is detectable in the ICTP test) in malignant ovarian cancer tissue has been reported to be lower and that of bivalently cross-linked and non-cross-linked collagen has been reported to be higher than in benign tumors, the source of excess ICTP in the circulation of ovarian cancer patients is most likely the degradative d amage of soft tissues surrounding the progressively growing malignant lesio ns. The serum ICTP concentration can thus be regarded as an indicator of th e invasion of ovarian cancer. Such information is not available by conventi onal methods. Therefore, the ICTP test will improve the accuracy of predict ing clinical outcome in this disease.