Prognostic value of human epididymis protein 4 in endometrial cancer and its utility for surgical staging
Language English Country Australia Media print-electronic
Document type Journal Article
PubMed
26223178
DOI
10.1111/jog.12764
Knihovny.cz E-resources
- Keywords
- endometrial cancer, human epididymis protein 4, risk status of disease, surgical staging,
- MeSH
- CA-125 Antigen blood MeSH
- Carcinoma, Endometrioid blood pathology MeSH
- Humans MeSH
- Membrane Proteins blood MeSH
- Myometrium pathology MeSH
- Biomarkers, Tumor blood MeSH
- Endometrial Neoplasms blood pathology MeSH
- WAP Four-Disulfide Core Domain Protein 2 MeSH
- Proteins metabolism MeSH
- Neoplasm Staging MeSH
- Check Tag
- Humans MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Names of Substances
- CA-125 Antigen MeSH
- Membrane Proteins MeSH
- MUC16 protein, human MeSH Browser
- Biomarkers, Tumor MeSH
- WAP Four-Disulfide Core Domain Protein 2 MeSH
- Proteins MeSH
- WFDC2 protein, human MeSH Browser
AIM: An optimal surgical staging in the group of patients with the high-risk type of endometrial cancer is often limited by age and serious internal comorbidities. Therefore, in this study we focused on human epididymis protein 4 and its contribution to the preoperative differentiation of prognostically distinct groups of patients and to individualized surgical treatment as compared with cancer antigen (CA) 125 and imaging methods. MATERIAL AND METHODS: The study included 115 patients with endometrioid adenocarcinoma diagnosed through endometrial biopsy. Before the final operation, blood sampling was performed for the determination of human epididymis protein 4 (HE4) and CA125 levels. Serum levels of both biomarkers were analyzed in relation to individual prognostic factors (stage of disease, depth of myometrial invasion, tumor grade, risk type of disease). RESULTS: In the case of HE4, we demonstrated a statistically significant difference (P < 0.001) between patients with low and high risk of the disease. In our model, achieving the maximum sum of sensitivity and specificity, HE4 shows a sensitivity of 72.4% and a specificity of 75.4% for the cut-off 76.5 pmol/L and is a better predictor in distinguishing the high-risk patients than CA125 (area under the curve 0.77 for HE vs 0.71 for CA125). CONCLUSION: HE4 is a marker that could complement the findings of imaging techniques and that may be useful in decision-making on how to individualize surgical staging. The possibility of its introduction as an independent marker in routine practice remains, at the moment however, limited. The optimal cut-off for HE4 has not been established yet and further studies are needed.
Department of Biochemistry Faculty Hospital Brno Brno Czech Republic
Department of Pathology Faculty Hospital Brno Brno Czech Republic
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