Diagnostic and prognostic values of preoperative serum levels of YKL-40, HE-4 and DKK-3 in endometrial cancer

Kemik, Pınar; Saatli, Bahadır; Yıldırım, Nuri; Kemik, Vahit Doğu; Deveci, Banu; Terek, Mustafa Coşan; Koçtürk, Semra; Koyuncuoğlu, Meral; Saygılı, Uğur

doi:10.1016/j.ygyno.2015.11.020

Cited by 38 publications

(30 citation statements)

References 29 publications

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“…Diagnostic serum levels range from 50 to 70 pmol/l with a minimum 78% sensitivity and 100% specificity, even in early-stage disease [50]. Kemik et al showed that serum HE4 levels are significantly higher in advanced stage disease, particularly in relation to LVSI, lower uterine segment involvement, endocervical stromal involvement and deep myometrial invasion [49]. Similar findings were previous identified by Bignotti et al [51].…”

Section: Blood-based Protein Biomarkerssupporting

confidence: 61%

“…The most promising serum biomarker for endometrial cancer so far is Human Epididymis protein 4 (HE4). Several studies have looked at HE4 as a diagnostic and prognostic biomarker, either alone or alongside markers such as CA-125, CA724 and CA19-9 [47], serum amyloid-A (SA-A) [48] and YKL-40 & DKK-3 [49]. Diagnostic serum levels range from 50 to 70 pmol/l with a minimum 78% sensitivity and 100% specificity, even in early-stage disease [50].…”

Section: Blood-based Protein Biomarkersmentioning

confidence: 99%

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The role of biomarkers in endometrial cancer and hyperplasia: a literature review

et al. 2019

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Introduction: Endometrial cancer is the most common gynaecological cancer and its incidence is rising due to increasing obesity rates. We are also seeing an increasing trend of young women diagnosed with either endometrial cancer or its precancerous state, endometrial hyperplasia. Diagnosis is dependent on invasive testing and there is no screening tool available for either general or high-risk population groups.Whilst vast amounts of research have been undertaken in higher-profile cancers such as ovarian and cervical, endometrial cancer is comparatively less investigated. Aim: In this literature review, we summarise the existing literature in understanding the role of tumour biomarkers for endometrial cancer and its preceding condition of endometrial hyperplasia. Method: NICE Healthcare Databases Search tool was used to search Embase, Medline and PubMed databases for relevant articles. Conclusion: There is currently no routinely used biomarker in endometrial cancer for diagnostic or prognostic purposes. Given the establishment of new genomic classifications of endometrial cancers, the use of biomarkers to drive therapeutic approaches will be the cornerstone for individualised cancer care in the coming decades. ARTICLE HISTORY

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Section: Blood-based Protein Biomarkerssupporting

confidence: 61%

Section: Blood-based Protein Biomarkersmentioning

confidence: 99%

The role of biomarkers in endometrial cancer and hyperplasia: a literature review

et al. 2019

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“…7,8 There were also some studies that combined multiple serum markers. 9,10 However, their results were not very satisfactory. For example, the combined detection of HE4, CA125, CA724, and CA199 was not very greatly superior to the combined detection of any 3 of them alone.…”

Section: Introductionmentioning

confidence: 95%

A New Risk Index Combining d-Dimer, Fibrinogen, HE4, and CA199 Differentiates Suspecting Endometrial Cancer From Patients With Abnormal Vaginal Bleeding or Discharge

Liu

et al. 2020

Technol Cancer Res Treat

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Purpose: To establish an efficient new risk index for screening patients with endometrial cancer from patients with abnormal vaginal bleeding or discharge. Method: A total of 254 patients with abnormal vaginal bleeding or discharge were included in this study. Several candidate markers, including HE4, CA125, CA199, CA153, AFP, CEA, d-dimer, and fibrinogen, were employed. A new risk index for endometrial cancer screening was established by binary logistic regression. The diagnostic value of the candidate markers and the new risk index were assessed by a receiver operating characteristic curve, sensitivity, and specificity. Results: The most valuable diagnostic indicator for endometrial cancer was HE4, followed by d-dimer and then fibrinogen (area under the receiver operating characteristic curve: HE4 = 0.794, d-dimer = 0.717, fibrinogen = 0.690). The new risk index was superior to a single application of markers and a widely used combination (HE4 and CA125). At the ideal cutoff level, the sensitivity and specificity were 91.34% and 70.08%, respectively. In addition, only patients without organic disease served as controls, which further increase its performance (area under the receiver operating characteristic curve = 0.932, sensitivity = 94.49%, and specificity = 77.42%). Conclusions: The new risk index combining HE4, d-dimer, fibrinogen, and CA199 was the ideal combination for the screening of endometrial cancer. As a simple, rapid, nondestructive detection method, the new risk index is worth promotion in clinical practice, especially in primary medical institutions.

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“…To date, many studies have been conducted to identify EC protein biomarkers, mainly in tissue and serum samples (12)(13)(14), but none of them have been translated into clinical utility. In a previous study, we demonstrated that the fluid fraction of uterine aspirates are minimally invasive samples with an important value for the screening of EC protein biomarkers (15).…”

Section: Introductionmentioning

confidence: 99%

Targeted Proteomics Identifies Proteomic Signatures in Liquid Biopsies of the Endometrium to Diagnose Endometrial Cancer and Assist in the Prediction of the Optimal Surgical Treatment

Martínez‐García

Lesur

Devis

et al. 2017

Clinical Cancer Research

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Endometrial cancer (EC) diagnosis relies on the observation of tumor cells in endometrial biopsies obtained by aspiration (i.e., uterine aspirates), but it is associated with 22% undiagnosed patients and up to 50% of incorrectly assigned EC histotype and grade. We aimed to identify biomarker signatures in the fluid fraction of these biopsies to overcome these limitations. The levels of 52 proteins were measured in the fluid fraction of uterine aspirates from 116 patients by LC-PRM, the latest generation of targeted mass-spectrometry acquisition. A logistic regression model was used to assess the power of protein panels to differentiate between EC and non-EC patients and between EC histologic subtypes. The robustness of the panels was assessed by the "leave-one-out" cross-validation procedure performed within the same cohort of patients and an independent cohort of 38 patients. The levels of 28 proteins were significantly higher in patients with EC ( = 69) compared with controls ( = 47). The combination of MMP9 and KPYM exhibited 94% sensitivity and 87% specificity for detecting EC cases. This panel perfectly complemented the standard diagnosis, achieving 100% of correct diagnosis in this dataset. Nine proteins were significantly increased in endometrioid EC ( = 49) compared with serous EC ( = 20). The combination of CTNB1, XPO2, and CAPG achieved 95% sensitivity and 96% specificity for the discrimination of these subtypes. We developed two uterine aspirate-based signatures to diagnose EC and classify tumors in the most prevalent histologic subtypes. This will improve diagnosis and assist in the prediction of the optimal surgical treatment. .

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Diagnostic and prognostic values of preoperative serum levels of YKL-40, HE-4 and DKK-3 in endometrial cancer

Cited by 38 publications

References 29 publications

The role of biomarkers in endometrial cancer and hyperplasia: a literature review

The role of biomarkers in endometrial cancer and hyperplasia: a literature review

A New Risk Index Combining d-Dimer, Fibrinogen, HE4, and CA199 Differentiates Suspecting Endometrial Cancer From Patients With Abnormal Vaginal Bleeding or Discharge

Targeted Proteomics Identifies Proteomic Signatures in Liquid Biopsies of the Endometrium to Diagnose Endometrial Cancer and Assist in the Prediction of the Optimal Surgical Treatment

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