Carboxyterminal telopeptide of type I collagen (ICTP) in predicting prognosis in epithelial ovarian cancer

Objective. The aim of this study was to assess the prognostic value of seru m carboxyterminal telopeptide of type I collagen (ICTP) in ovarian cancer. Serum CA125 was used as a reference marker. Methods. Forty-five patients with epithelial ovarian cancer were monitored with serial measurements of serum concentrations of ICTP, a degradation pro duct of type I collagen likely to come about via the matrix metalloproteina se pathway. Results. The patients with a good prognosis had significantly lower serum I CTP concentrations than the patients with a poor prognosis both before the operation and at all the postoperative time points studied (3, 6, 9, 12, 18 , and 24 months), whereas a corresponding difference in CA125 was first see n after a 12-month follow-up. Tn multivariate regression analysis, the g-mo nth serum ICTP concentration remained the only independent prognostic indic ator of all biochemical, clinical, and histological variables. The postoper ative serum ICTP concentration did not correlate with the clinical stage, t he grade of differentiation, or the presence of residual tumor. In contrast to ICTP, postoperative serum CA125 correlated with the clinical stage and the presence of residual tumor. Conclusions. Because our ICTP test does not detect defectively cross-linked carboxyterminal telopeptides of type I collagen, which is the predominant form in malignant ovarian tissue, the excess ICTP of ovarian cancer patient s must originate from the tissue around the tumor, where the malignancy is causing tissue damage. As an indicator of invasion, the serum ICTP test ope ns up new possibilities to assess the clinical behavior of ovarian cancer a nd, in the future, also the effect of possible antiproteinase treatment in ovarian cancer. (C) 2001 Academic Press.