Of the cases included

in this study, 76% (i.e. 35 cases) were early stage disease (i.e. Stages I and II). The median CA125 plasma concentrations were 13 U/ml (range 3 – 84) for controls and 502 U/ml (5 – 10,209) for cases. In 3 controls, CA125 concentration was ≥ 35 U/ml. In 6 cases, CA125 concentration was < 35 U/ml. At a threshold of 35 U/ml, the sensitivity and specificity of CA125 were 87.0 and 95.1%, respectively. Variation with Disease State, Stage and Tumor Type The variation in plasma analyte concentrations for control and case cohorts is presented in Figure 1. Median plasma concentrations of immunoreactive Trichostatin A MDK, AGR2 and CA125 were significantly greater in the case cohort (909 pg/ml, 765 pg/ml and 502 U/ml, respectively n = 46) than in the control (383 pg/ml, 188 pg/ml MEK162 and 13 U/ml, respectively n = 61)

cohort (p < 0.001, as assessed by Mann Whitney tests). Within control or case cohorts, plasma concentrations of AGR2 displayed no significant correlations with either CA125 or midkine concentrations (as assessed by Spearman's correlation, p > 0.05). Within the case cohort, MDK plasma concentrations significantly correlated with CA125 concentrations (ρ = 0.383, p < 0.01). Data were further analysed with respect to tumor type and Stage (Table 3). No statistically significant effects of either tumor type or stage on biomarker plasma concentrations were identified (Kruskal-Wallis one-way analysis of variance, p > 0.05). Figure 1 Plasma biomarker concentrations. The median plasma concentration within each group (normal women (controls) n = 61 and women with ovarian PS 341 cancer (cases) n = 46) is represented by the horizontal line. Biomarker concentrations were

significantly greater in case cohorts (solid symbols) when compared to their respective control cohort (open symbols) (p < 0.001, Mann Whitney tests). Data are presented as log (plasma concentration). CA125 as U/ml; and MDK and AGR2 as pg/ml. Table 3 Case cohort variation in plasma analyte concentration by stage of disease and tumor type, as assessed by Kruskal-Wallis One Montelukast Sodium Way Analysis of Variance (Stage and Tumor Type). Analyte Stage n = 45# (p) Tumor Type n = 43† (p) MDK 0.722 0.839 AGR2 0.776 0.334 CA125 0.524 0.214 # 1 sample was unstaged † 3 samples were not typed Receiver Operator Characteristic Curve Analysis and Multi-analyte Modelling ROC curves were generated for each individual analyte. The area under the curve (AUC) for MDK, AGR2 and CA125 was: 0.753 ± 0.049; 0.768 ± 0.048; 0.934 ± 0.027, respectively (AUC ± SEM). There was no significant difference between the AUC for midkine and AGR2. The AUC for CA125 was significantly greater than that for both midkine and AGR2 (p < 0.001, Table 4). Table 4 Comparison of AUC for MDK, AGR2, CA125 and multi-analyte panel Data represent AUC ± standard errors (SEM). Analyte AUC ± SEM p CA125 0.934 ± 0.027   MDK 0.753 ± 0.049 < 0.001 AGR2 0.768 ± 0.048 = 0.001 Multi-analyte Algorithm 0.988 ± 0.011 = 0.