Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Republic of Korea.
Eur J Obstet Gynecol Reprod Biol. 2011 Oct;158(2):338-42. doi: 10.1016/j.ejogrb.2011.05.021. Epub 2011 Jun 17.
The purpose of this study was to evaluate the prognostic significance of serum human epididymis protein 4 (HE4) level in patients with epithelial ovarian cancer.
A total of 78 women diagnosed with a pelvic mass and operated on in our institute comprised our cohort. Forty-five of these were diagnosed with epithelial ovarian cancer and treated with debulking surgery, followed by taxane and platinum-based chemotherapy as clinically indicated. Preoperatively obtained serum samples were analyzed for levels of HE4 and CA125.
The elevated serum HE4 level was related to advanced stage and serous type of cancer. The median duration of the follow-up was 35.1 months. In advanced stage, the median progression-free survival (PFS) of patients with elevated serum HE4 levels was 20.1 months (95% CI, 15.7-24.6 months), whereas that of patients with normal serum HE4 level was 24.2 months (95% CI, 13.9-34.6 months) (p=0.029). Independent predictors for PFS in patients with advanced stage EOC included serum HE4 level (hazard ratio 2.24; 95% CI, 1.14 to 6.84; p=0.048).
Our results demonstrated that an elevated serum HE4 level was related to the advanced stage of epithelial ovarian cancer. An elevated serum level of HE4 is a poor prognostic factor for PFS in patients with epithelial ovarian cancer who were treated with debulking surgery and adjuvant taxane and platinum-based chemotherapy. The serum HE4 level is a promising indicator for the progression of cancer as well as a biomarker for the detection of epithelial ovarian cancer.
本研究旨在评估血清人附睾蛋白 4（HE4）水平对上皮性卵巢癌患者的预后意义。
本队列纳入了在我院因盆腔肿块就诊并接受手术的 78 名女性。其中 45 例被诊断为上皮性卵巢癌，并根据临床指征接受了肿瘤细胞减灭术，随后接受紫杉烷类和铂类化疗。术前获得的血清样本用于分析 HE4 和 CA125 水平。
血清 HE4 水平升高与晚期和浆液型癌症有关。中位随访时间为 35.1 个月。在晚期，血清 HE4 水平升高患者的无进展生存期（PFS）中位数为 20.1 个月（95%CI，15.7-24.6 个月），而血清 HE4 水平正常患者的 PFS 中位数为 24.2 个月（95%CI，13.9-34.6 个月）（p=0.029）。晚期 EOC 患者 PFS 的独立预测因素包括血清 HE4 水平（风险比 2.24；95%CI，1.14-6.84；p=0.048）。
我们的结果表明，血清 HE4 水平升高与上皮性卵巢癌的晚期有关。血清 HE4 水平升高是接受肿瘤细胞减灭术和辅助紫杉烷类和铂类化疗的上皮性卵巢癌患者 PFS 预后不良的因素。血清 HE4 水平是癌症进展的有前途的指标，也是上皮性卵巢癌检测的生物标志物。
