The discovery that molecular changes are present in tissues from the nonmalignant ovary in women undergoing surgery for contralateral ovarian cancer may lead to a biomarker for early disease, according to an article in the April issue of Gynecologic Oncology.

In the current study, American researchers took tissue samples from the normal ovary of 29 patients with unilateral ovarian cancer, 19 women with unilateral benign ovarian pathology, and 39 control women with bilaterally normal ovaries.

Histologic examination showed that epithelial stratification and nuclear atypical features were significantly more common in cancer patients than in the two control groups. Inclusion cysts were also statistically significantly more common in patients than in normal controls, and in higher numbers.

Samples were also analyzed for Bcl-2 (apoptosis inhibitor), Ki-67 (a proliferation marker), and p53 (a tumor suppressor). Bcl-2 overexpression was statistically significantly more common in women with contralateral ovarian cancer (39 percent) than in women with bilaterally normal ovaries (15 percent); overexpression was present at an intermediate frequency (28 percent) in women with contralateral benign ovarian disease.

According to senior author Enrique Hernandez, MD, “Our study suggests that the normal ovaries of women with ovarian cancer have not only structural changes, but also molecular changes that are less frequently found in the ovaries of healthy women,” said Hernandez. Similar previous studies have been limited to women genetically predisposed to ovarian cancer.

“This study and others like it are building the foundation for better methods of early detection of ovarian cancer. If we are able to identify early changes along the path by which a normal ovarian cell turns into a cancerous ovarian cell, we might be able to develop a test to detect the disease earlier, even before it becomes cancerous,” added Hernandez.

The researchers plan to conduct further testing to confirm the changes observed in the current study are not the result of inflammation or injury to the ovary.