Microvesicle proteomic profiling of uterine liquid biopsy for ovarian cancer early detection

Georgina D. Barnabas, Keren Bahar-Shany, Stav Sapoznik, Limor Helpman, Yfat Kadan, Mario Beiner, Omer Weitzner, Nissim Arbib, Jacob Korach, Tamar Perri, Guy Katz, Anna Blecher, Benny Brandt, Eitan Friedman, David Stockheim, Ariella Jakobson-Setton, Ram Eitan, Shunit Armon, Hadar Brand, Oranit ZadokSarit Aviel-Ronen, Michal Harel, Tamar Geiger, Keren Levanon

Research output: Contribution to journalArticlepeer-review

39 Scopus citations


High-grade ovarian cancer (HGOC) is the leading cause of mortality from gynecological malignancies, because of diagnosis at a metastatic stage. Current screening options fail to improve mortality because of the absence of early-stage-specific biomarkers. We postulated that a liquid biopsy, such as utero-tubal lavage (UtL), may identify localized lesions better than systemic approaches of serum/plasma analysis. Further, while mutation-based assays are challenged by the rarity of tumor DNA within nonmutated DNA, analyzing the proteomic profile, is expected to enable earlier detection, as it reveals perturbations in both the tumor as well as in its microenvironment. To attain deep proteomic coverage and overcome the high dynamic range of this body fluid, we applied our method for microvesicle proteomics to the UtL samples. Liquid biopsies from HGOC patients (n 49) and controls (n 127) were divided into a discovery and validation sets. Data-dependent analysis of the samples on the Q-Exactive mass spectrometer provided depth of 8578 UtL proteins in total, and on average 3000 proteins per sample. We used support vector machine algorithms for sample classification, and crossed three feature-selection algorithms, to construct and validate a 9-protein classifier with 70% sensitivity and 76.2% specificity. The signature correctly identified all Stage I lesions. These results demonstrate the potential power of microvesicle-based proteomic biomarkers for early cancer diagnosis.

Original languageEnglish
Pages (from-to)865-875
Number of pages11
JournalMolecular and Cellular Proteomics
Issue number5
StatePublished - May 2019
Externally publishedYes


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