The Accuracy of Glutaminase (GLS) and Ca-125 Protein Levels in Diagnosing Presurgical Epithelial Type of Ovarian Cancer

Background: Ovarian cancer remains one of the leading causes of gynecologic cancer-related mortality, with epithelial-type ovarian carcinoma being the most common subtype. Accurate preoperative diagnosis is crucial for determining appropriate treatment strategies. While CA-125 is widely used as a tumor marker for ovarian cancer, its specificity and sensitivity remain limited. Recent studies suggest that glutaminase (GLS) may play a role in tumor metabolism, making it a potential biomarker for ovarian carcinoma diagnosis. Objective: This study aims to evaluate the diagnostic accuracy of GLS and CA-125 protein levels in distinguishing preoperative epithelial-type ovarian carcinoma from non-epithelial ovarian tumors in patients at Dr. Wahidin Sudirohusodo Hospital Makassar and its network hospitals. Results: The mean CA-125 and GLS levels in epithelial-type ovarian carcinoma patients were 540.61 ± 860.45 and 6.30 ± 1.91, respectively. At a cut-off of 259.6, CA-125 demonstrated a sensitivity of 44.44% and a specificity of 42.86%. Meanwhile, GLS with a cut-off of 5.675 exhibited a slightly better sensitivity and specificity at 53.09% and 57.41%, respectively. Despite this, both biomarkers showed inadequate significance in differentiating epithelial-type ovarian carcinoma from non-epithelial ovarian carcinoma. Conclusion: CA-125 and GLS levels alone do not provide sufficient diagnostic accuracy for preoperative differentiation of epithelial-type ovarian carcinoma. Further research is needed to explore their combined use with other biomarkers or imaging techniques to enhance diagnostic precision.