Ovarian cancer is one of the most insidious and aggressive forms of cancer. Due to asymptomatic symptoms, ovarian cancer is usually diagnosed in late stages (FIGO stage III or IV), when surgery and chemotherapy are not very effective. There is currently no effective screening program or suitable screening methods for ovarian cancer detection. In our study, we analyzed the diagnostic role of TK1 concentration, TK1 activity, CA 125, HE4, and ROMA index for the early detection of ovarian cancer in premenopausal and postmenopausal women compared to the control group. In addition, we also evaluated the role of TK1 specific activity (TK1 SA) based on the ratio between TK1a and TK1c for the early diagnosis of ovarian cancer and also in combination with traditional tumor markers such as CA 125, HE4, and ROMA index. At the Clinical Department of Gynecology in Ljubljana and at the Institute of Transfusion Medicine of the Republic of Slovenia, 198 samples were taken, among which were patients with borderline malignant ovarian tumors and ovarian cancer (N = 62), with benign tumors (N = 72) and healthy women as a control group (N = 64). We intended to test three hypotheses: 1. The TK1 concentration, TK1 activity, and their ratio are higher in patients with ovarian cancer compared to the benign tumor and the control group and will increase according to the stage of the disease. 2. Increased values of TK1 concentration and TK1 activity are associated with aggressiveness or disease prognosis. 3. The addition of TK1 concentration or TK1 activity to the ROMA index improved the specificity and sensitivity for the detection of ovarian cancer. Hypotheses 1 and 2 were partially confirmed, while hypothesis 3 was fully confirmed. Until now, there has been no published research using the combination of TK1 enzyme concentration and TK1 enzyme activity in the diagnosis of ovarian cancer. Overall, these results suggest that the TK1 SA enzyme ratio could complement the tumor markers CA 125 or HE4 in the detection of early stage ovarian cancer.
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