Preoperative Serum Human Epididymis Protein 4 Levels in Early Stage Endometrial Cancer: A Prospective Study

Background Endometrial cancer (EC) is the most common malignancy of the female reproductive tract. Despite years of research, the accurate screening strategy is still not available in this disease and it is usually diagnosed only after the clinical signs are present. The recent technological advances in analytical methodologies enabled detection of multiple molecules in one, small sample of biological materials. Such approach was undertaken in the presented study. Methods Concentrations of aldehyde dehydrogenase 1 family, member A1 (ALDH1A1), carbonic anhydrase IX (CA9), CD44, epithelial cell adhesion molecule (EpCAM), hepsin, kallikrein-6, mesothelin, midkine, neural cell adhesion molecule L1 (L1CAM), and transglutaminase 2 (TGM2) were measured using MAGPIX®System in plasma samples of 45 EC, 20 healthy controls and 11 patients with endometriosis. Results Significantly increased concentration in EC as compared to healthy controls were found in case of CD44 ( p < 0.001), EpCAM ( p = 0.033) and TGM2 ( p < 0.001). EpCAM and mesothelin concentrations differed based on FIGO stages. Regression analysis revealed marker panels with high accuracy in detection of EC. The highest AUC 0.937 was attributed to the 3-marker panel of CD44/TGM2/EpCAM (84% sensitivity, 100% specificity), FIGO IA samples were discriminated from more advanced stages of EC with the mesothelin/grade 1 model featuring AUC of 0.911 (95.24% sensitivity, 78.26% specificity). Conclusions Novel plasma biomarkers presenting good accuracy in diagnosing EC were found with TGM2 reported for the first time as plasma marker. It was also revealed that endometriosis may share similarities in the pattern of markers alterations characteristic for EC. Electronic supplementary material The online version of this article (10.1186/s12885-019-5556-x) contains supplementary material, which is available to authorized users.

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“…These results present similar accuracy as compared to blood derived markers reported by other research groups [30, 35, 41].…”

Section: Discussionsupporting

confidence: 90%

CD44, TGM2 and EpCAM as novel plasma markers in endometrial cancer diagnosis

et al. 2019

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“…To date, the well-investigated biomarkers for EC evaluation are cancer antigen 125 (CA-125) and human epididymis protein 4 (HE4). Multiple studies have demonstrated that both CA-125 and HE4 have potential prognostic properties (9)(10)(11)(12)(13). While, in comparison to CA-125, HE4 reveals a superior diagnostic accuracy to distinguish physiological, benign, or malignant gynecological diseases (9,14).…”

Section: Introductionmentioning

confidence: 99%

Diagnostic and Prognostic Values of Serum EpCAM, TGM2, and HE4 Levels in Endometrial Cancer

Lan

Wang

et al. 2020

Front. Oncol.

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Objectives: This study aims to investigate the diagnostic and prognostic values of EpCAM, TGM2, and HE4 in endometrial cancer (EC). Methods: In this study, 42 patients diagnosed with EC (EC group), 41 patients diagnosed with myoma (benign group), and 43 healthy women (healthy group), who applied to Affiliated Hospital of Xuzhou Medical University between March 2018-September 2019 were recruited. Serum EpCAM, TGM2, and IL-33 levels were measured by ELISA, while serum HE4 and CA-125 levels were measured by ECLIA. The serum markers listed above were also measured in 12 paired pre-and post-operative EC patients. The diagnostic and prognostic values of serum markers were analyzed. Results: The serum EpCAM, TGM2, HE4, CA-125, and IL-33 levels were significantly higher in the EC group. The sensitivity and specificity of combined detection of EpCAM and HE4 was 92.86 and 69.05%, which were significantly higher than using a single marker or other combinations. Among these markers, serum HE4 levels were significantly higher in patients with myometrial invasion, metastasis, and lymphovascular invasion (p = 0.006, p = 0.0004, p = 0.0004, respectively). And serum TGM2 levels were significantly decreased in post-operative than that of pre-operative EC patients (p < 0.001). Conclusions: The combination of EpCAM and HE4 showed the highest specificity and sensitivity in the diagnosis of EC. HE4 was successful in the detection of high-risk individuals preoperatively. Additionally, TGM2 might be a prognostic factor for EC.

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“…Also the sensitivity and the specificity of CA-125 is lower for EC than OC [21]. Several studies have shown that HE4 is a novel sensitive and specific biomarker for EC [23][24][25].…”

Section: He-4 In Endometrial Cancermentioning

confidence: 96%