<scp>HE</scp>4 tumor marker as a predictive factor for lymphatic metastasis in endometrial cancer

Romera, Andrea Espiau; Cuesta-Guardiola, Tatiana; Vielba, Marta Benito; Torralba, Carlos De Bonrostro; Coronado, Pluvio; Baquedano, Laura

doi:10.1002/ijgo.13140

Cited by 20 publications

(23 citation statements)

References 26 publications

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“…To compare the diagnostic value of the studied AFs with biomarkers that are in clinical use, we compared the ROC curves for sTie-2, G-CSF, and leptin with those for CA-125 and HE4. CA-125 and HE4 have been extensively studied in ovarian and EC, and their diagnostic and prognostic values in gynecological cancers have been reported [16,[55][56][57]. This comparison revealed that sTie-2, G-CSF, and leptin have similar AUC values as CA-125 and HE4 for the separation of EC and control patients.…”

Section: Discussionmentioning

confidence: 84%

Tie-2, G-CSF, and Leptin as Promising Diagnostic Biomarkers for Endometrial Cancer: A Pilot Study

Roškar

Klančič

Knific

et al. 2021

JCM

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Preoperative determination of the extent of endometrial cancer (EC) would avoid the complications associated with radical surgery. Screening of patients’ plasma biomarkers might enable a more precise diagnosis of EC and a tailored treatment approach. This prospective case-control monocentric pilot study included 76 postmenopausal women (38 endometrioid EC patients and 38 control patients with benign gynecological conditions), and 37 angiogenic factors (AFs) were investigated as potential biomarkers for EC. AF concentrations in preoperative plasma samples were measured using Luminex xMAP™ multiplexing technology. The plasma levels of sTie-2 and G-CSF were significantly lower in EC compared to control patients, whereas the plasma levels of leptin were significantly higher in EC patients. Neuropilin-1 plasma levels were significantly higher in patients with type 2 EC (grade 3) compared to patients with lower grade cancer or controls. Follistatin levels were significantly higher in patients with lymphovascular invasion, and IL-8 plasma levels were significantly higher in patients with metastases. If validated, the plasma concentrations of the indicated AFs could represent an important additional diagnostic tool for the early detection and characterization of EC. This could guide the decision-making on the extent of surgery. Further studies with larger patient numbers are currently ongoing.

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Section: Discussionmentioning

confidence: 84%

Tie-2, G-CSF, and Leptin as Promising Diagnostic Biomarkers for Endometrial Cancer: A Pilot Study

Roškar

Klančič

Knific

et al. 2021

JCM

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“…Endometrial lesions are common gynecological diseases, which have a great impact on women's physical and mental health and quality of life. In particular, endometrial cancer is one of the most common gynecological malignancies (1)(2)(3)(4)(5) and accounts for 20%-30% of malignant tumors of the female reproductive tract (6). The prognosis of early endometrial cancer patients is generally good, with a 5-year survival rate of >90% for Stage IA disease (7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

“…It is highly expressed in the serum of patients with malignant tumors but may be increased in varying degrees in the serum of benign lesions or healthy patients. HE4 has been recently identified as a potential biomarker in endometrial carcinoma (3,4,27,28). Some studies (3,5,(29)(30)(31)(32)(33) showed that CA125 and HE4 were significantly correlated with histological grade, stage, lymph node metastasis, muscular invasion, and cervical involvement.…”

Section: Introductionmentioning

confidence: 99%

Combination IETA Ultrasonographic Characteristics Simple Scoring Method With Tumor Biomarkers Effectively Improves the Differentiation Ability of Benign and Malignant Lesions in Endometrium and Uterine Cavity

Lin

Zhao²,

Zhu³

et al. 2021

Front. Oncol.

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ObjectivesTo evaluate International Endometrial Tumor Analysis (IETA) ultrasonographic characteristics simple scoring method and tumor biomarkers for the diagnosis of uterine cavity and endometrial lesions.MethodsWe classified and scored the normalized description of IETA ultrasonic characteristics, according to IETA expert consensus literature, previous IETA-related research articles, and the previous research experience of this project group. We conducted a retrospective analysis of the ultrasound images of 594 patients enrolled from January 2017 to June 2020, scored them item by item, and finally calculated the total score of each case. Meanwhile, we combined the results of seven tumor biomarkers. The objective was to evaluate the sensitivity, specificity, coincidence rate, and the area under receiver operating characteristic (ROC) curve of IETA ultrasonographic characteristics simple scoring method and tumor biomarkers for benign and malignant uterine cavity or endometrial lesions. The diagnostic efficiency between the combined method and the single method was compared.ResultsA total of 594 cases were confirmed by postoperative pathology or surgery records, including 475 benign lesions and 119 malignant lesions. In the simple ultrasound scoring method, the average score of benign lesions was 3.879 ± 1.279 and that of malignant lesions was 9.676 ± 4.491. If ≥6.5 points was taken as the cutoff value for the judgment of malignant lesions, the sensitivity, specificity, coincidence rate, and the area under receiver operating characteristic (ROC) curve (AUC) were 76.5%, 96.0%, 92.1%, and 0.935, respectively. The difference in tumor antigen 19-9 (CA19-9) and human epididymal protein 4 (HE4) between benign and malignant lesions was statistically significant (all p ≤ 0.01). The other five tumor biomarkers (CA125, CA15-3, SCC-Ag, AFP, and CEA) showed no statistically significant difference in benign and malignant lesions. If the value of CA19-9 ≥13.96 U/ml was taken as cutoff value, the sensitivity, specificity, and coincidence rate of the diagnosis of endometrial benign and malignant lesions were 54.8%, 74.7%, and 70.7%, respectively, and the AUC was 0.620. If the value of HE4 ≥ 39.075 pmol/L was taken as cutoff point, the sensitivity, specificity, coincidence rate, and AUC were 77.4%, 67.9%, 69.8%, and 0.796, respectively. The sensitivity was increased to 97.6% and the AUC was 0.939 when IETA ultrasound characteristics simple scoring method combined CA19-9 and HE4 in parallel test.ConclusionsIn IETA ultrasound characteristics simple scoring method, with ≥6.5 points as the cutoff value, it could quickly and accurately assess the benign and malignant in uterine cavity and endometrial lesions, with high diagnostic value. The diagnostic efficacy of seven tumor biomarkers was all mediocre. Combining with these two methods, the comprehensive diagnosis could improve sensitivity and accuracy and reduce the risk of missed diagnosis.

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“…Currently, there is no consensus on the possible application of HE4 as a preoperative marker for the endometrioid subtype of endometrial cancer and results are heterogeneous. However, there seems to be a correlation between endometrial cancer prognostic factors and preoperative HE4 levels 9‐11 …”

Section: Introductionmentioning

confidence: 99%

“…However, there seems to be a correlation between endometrial cancer prognostic factors and preoperative HE4 levels. [9][10][11] Some studies do not take into account the histologic subtype of endometrial cancer, although there is evidence of substantial differences in patient prognosis regarding the histologic subtype. 12,13 A preoperative tumor marker that can predict advanced stage or nodal metastasis could be helpful in planning a more individualized surgical procedure in endometrioid endometrial cancer.…”

Section: Introductionmentioning

confidence: 99%

Value of preoperative HE4 as predictor of advanced disease in endometrioid endometrial cancer

Romera

Coronado

Ezquerro

et al. 2020

Intl J Gynecology & Obste

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Objective To explore the predictive value of serum human epididymis protein 4 (HE4) marker in the preoperative prediction of the risk of advanced disease in the endometrioid subtype of endometrial cancer, and its association with poor prognostic factors. In addition, a cut‐off value of HE4 was defined to classify patients according to these results. Methods Prospective and multicenter cohort analytical pilot study of patients operated for endometrial cancer at the Miguel Servet University Hospital of Zaragoza (Spain) and the Complejo Universitario of León (Spain) from January 2017 to May 2019. Preoperative serum levels of HE4 were analyzed by clinical and pathologic characteristics. Results In all, 126 patients were included. A statistically significant association was found between the preoperative HE4 value and node involvement (P = 0.008), late‐stage disease (P = 0.003), high histologic grade (P = 0.007), deep myometrial invasion (P = 0.001), lymphovascular space invasion (P = 0.001), and other pathologic factors. In addition, an HE4 cut‐off value (156.4 pmol/L) has been determined to predict, preoperatively, which patients will present with early stage disease. Conclusions The preoperative marker HE4 is a useful tool in the preoperative study of patients with endometrial cancer as it relates to late‐stage disease as well as other prognostic factors in the endometrioid subtype of endometrial cancer.

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HE4 tumor marker as a predictive factor for lymphatic metastasis in endometrial cancer

Cited by 20 publications

References 26 publications

Tie-2, G-CSF, and Leptin as Promising Diagnostic Biomarkers for Endometrial Cancer: A Pilot Study

Tie-2, G-CSF, and Leptin as Promising Diagnostic Biomarkers for Endometrial Cancer: A Pilot Study

Combination IETA Ultrasonographic Characteristics Simple Scoring Method With Tumor Biomarkers Effectively Improves the Differentiation Ability of Benign and Malignant Lesions in Endometrium and Uterine Cavity

Value of preoperative HE4 as predictor of advanced disease in endometrioid endometrial cancer

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