Prognostic value of human epididymis protein 4 in endometrial cancer and its utility for surgical staging.

Abstract

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.

• Authors: Lubos Minar, Ivanka Klabenesova, Eva Jandakova, Filip Zlamal, Julie Bienertova-Vasku
• Journal: The journal of obstetrics and gynaecology research (J Obstet Gynaecol Res) Vol. 41 Issue 10 Pg. 1644-52 (Oct 2015) ISSN: 1447-0756 [Electronic] Australia
• PMID: 26223178 (Publication Type: Journal Article)
• Copyright: © 2015 Japan Society of Obstetrics and Gynecology.

Chemical References

• Biomarkers, Tumor
• CA-125 Antigen
• MUC16 protein, human
• Membrane Proteins
• Proteins
• WAP Four-Disulfide Core Domain Protein 2
• WFDC2 protein, human

Topics

• Biomarkers, Tumor (blood)
• CA-125 Antigen (blood)
• Carcinoma, Endometrioid (blood, pathology)
• Endometrial Neoplasms (blood, pathology)
• Female
• Humans
• Membrane Proteins (blood)
• Myometrium (pathology)
• Neoplasm Staging
• Proteins (metabolism)
• WAP Four-Disulfide Core Domain Protein 2