BACKGROUND: We sought to identify candidate serum biomarkers for the detection and surveillance of EOC. Based on RNA-Seq transcriptome analysis of @entity1 -derived @entity5 , highly expressed secreted proteins were identified using a bioinformatic approach. METHODS: RNA-Seq was used to quantify @entity43 transcriptomes. Paired end sequencing of 22 flash frozen @entity5 was performed. Sequence alignments were processed with the program ELAND, expression levels with ERANGE and then bioinformatically screened for secreted protein signatures. Serum samples from @entity1 with benign and malignant pelvic masses and serial samples from @entity1 during chemotherapy regimens were measured for @entity12561 by ELISA. Student's t Test, ANOVA, and ROC curves were used for statistical analysis. RESULTS: Insulin-like growth factor binding protein ( @entity12561 ) was consistently present in the top 7.5% of all expressed genes in all @entity5 samples. We then screened serum samples to determine if increased @entity5 expression correlated with serum expression. In an initial discovery set of 21 samples, @entity12561 levels were found to be elevated in @entity1 , including those with early stage disease and normal @entity10224 levels. In a larger and independent validation set (82 controls, 78 cases), @entity12561 levels were significantly increased (p < 5   10-5). @entity12561 levels were ~3  greater in @entity1 with malignant pelvic masses compared to @entity1 with benign masses. ROC sensitivity was 73% at 93% specificity (AUC 0.816). In @entity1 receiving chemotherapy, average @entity12561 levels were below the ROC-determined threshold and lower in NED @entity1 compared to AWD @entity1 . CONCLUSIONS: This study, the first to our knowledge to use RNA-Seq for biomarker discovery, identified @entity12561 as overexpressed in @entity43 @entity1 . Beyond this, these studies identified two additional intriguing findings. First, @entity12561 can be elevated in early stage disease without elevated @entity10224 . Second, @entity12561 levels are significantly elevated with malignant versus benign disease. These findings provide the rationale for future validation studies.

XXXX @entity5 and serum levels are increased across all stages of @entity43 .

@entity1 :: ('9606', 'Species') :: ['women', 'patients', 'patient'] @entity43 :: ('MESH:D010051', 'Disease') :: ['ovarian cancer', 'papillary serous ovarian cancer'] @entity12561 :: ('3487', 'Gene') :: ['IGFBP-4'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'tumors'] @entity10224 :: ('94025', 'Gene') :: ['CA125']
@entity12561 :: (3487,Gene) :: ['IGFBP-4']
