Comparative Evaluation of Circulating Serum Hormone Assays in Patients with Ovarian Malignancies: A Case–Control Analysis

Abstract

Background: Ovarian malignancy develops within a complex endocrine environment, and alterations in reproductive hormones may reflect changes in ovarian function, reproductive aging, and tumor-related biology. However, the combined circulating profile of gonadotropins, progesterone (P4), and prolactin (PRL) in ovarian cancer remains incompletely characterized. Objective: This study aimed to compare serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), P4, and PRL concentrations between women with ovarian cancer and healthy controls and to evaluate their correlations and discriminatory performance. Materials and Methods: This case–control study included 100 women at a tertiary care center in Western Maharashtra, comprising 50 women with ovarian cancer and 50 healthy controls. Serum LH, FSH, P4, and PRL were measured using standard immunoassay techniques. Group differences were assessed using the Mann–Whitney U test, associations using Spearman’s rank correlation, and discriminatory performance using receiver operating characteristic (ROC) analysis. Results: FSH and PRL were significantly higher in women with ovarian cancer, whereas P4 was significantly lower; LH showed no significant between-group difference. Age correlated positively with LH (ρ = 0.528, P < 0.001) and FSH (ρ = 0.749, P < 0.001) and negatively with P4 (ρ = −0.714, P < 0.001). The strongest inter-hormonal association was the inverse correlation between FSH and P4 (ρ = −0.778, P < 0.001). PRL showed the highest discriminatory performance (area under the curve [AUC] = 0.780), followed by FSH (AUC = 0.636), whereas LH showed poor discrimination and P4 demonstrated an inverse ROC pattern. Conclusion: Ovarian malignancy was associated with a distinct endocrine profile characterized by higher FSH and PRL and lower P4 levels. PRL showed the strongest discriminatory ability, although its specificity was limited. These findings suggest that reproductive hormones may provide complementary insight into the endocrine milieu of ovarian cancer but should not be used as stand-alone diagnostic markers.