Capriglione Stella, Plotti Francesco, Miranda Andrea, Ricciardi Roberto, Scaletta Giuseppe, Aloisi Alessia, Guzzo Federica, Montera Roberto, Angioli Roberto
Department of Obstetrics and Gynaecology, Campus Bio Medico University of Rome, Via Alvaro del Portillo, 200-00128, Rome, Italy,
Tumour Biol. 2015 Jun;36(6):4151-6. doi: 10.1007/s13277-015-3049-3. Epub 2015 Jan 11.
This study aims to investigate the correlation between preoperative human epididymis protein 4 (HE4) levels, endometrial cancer (EC) staging, and ideal cutoff for stage prediction. All EC patients, treated within January 2009 and February 2014 at the Division of Gynaecologic Oncology of the University Campus Bio-Medico of Rome, were considered for the study. For the first part of the study, we consider an HE4 cutoff of 70 pmol/L. Histotypes (endometrioid versus non-endometrioid), grading (G1, G2, G3), and stage were correlated with HE4 levels. In the second part of the study, the logistic regression was performed in stepwise mood to identify the ideal HE4 cutoff for stage prediction. Two hundred thirty-two patients with surgically staged EC and preoperative HE4 dosage were included in the study. We found that higher HE4 levels correlate with undifferentiated grading (p < 0.05). Moreover, we found that 42, 77, 90, 93 and 100 % of patients classified as International Federation of Gynecology and Obstetrics (FIGO) stage IA, IB, II, III, and IV, respectively, presented HE4 levels above the standard cutoff of 70 pmol/L. Based on receiver operating characteristic (ROC) curves, we found the ideal HE4 cutoff as follows: 61.3 pmol/L for FIGO stage IA (sensitivity = 82.3 % and specificity = 96 %), 89.2 pmol/L for FIGO stage IB (sensitivity = 83.3 % and specificity = 96 %), 104.3 pmol/L for FIGO stage II (sensitivity = 80.9 % and specificity = 98.6 %), 152.6 pmol/L for FIGO stage III (sensitivity = 92.5 % and specificity = 98.6 %), and 203.8 pmol/L for FIGO stage IV (sensitivity = 81.8 % and specificity = 99.3 %). Our results suggest a potential role of HE4 in EC stage prediction.
本研究旨在探讨术前人附睾蛋白4（HE4）水平、子宫内膜癌（EC）分期以及分期预测的理想临界值之间的相关性。纳入了2009年1月至2014年2月期间在罗马生物医学大学校园妇科肿瘤学部接受治疗的所有EC患者进行研究。在研究的第一部分，我们将HE4临界值设定为70 pmol/L。组织学类型（子宫内膜样癌与非子宫内膜样癌）、分级（G1、G2、G3）和分期与HE4水平相关。在研究的第二部分，采用逐步回归法进行逻辑回归分析，以确定用于分期预测的理想HE4临界值。本研究纳入了232例经手术分期的EC患者及术前HE4检测数据。我们发现较高的HE4水平与未分化分级相关（p < 0.05）。此外，我们发现国际妇产科联盟（FIGO）分期为IA、IB、II、III和IV期的患者中，分别有42%、77%、90%、93%和100%的患者HE4水平高于70 pmol/L的标准临界值。基于受试者工作特征（ROC）曲线，我们得出以下理想的HE4临界值：FIGO IA期为61.3 pmol/L（灵敏度 = 82.3%，特异性 = 96%），FIGO IB期为89.2 pmol/L（灵敏度 = 83.3%，特异性 = 96%），FIGO II期为104.3 pmol/L（灵敏度 = 80.9%，特异性 = 98.6%），FIGO III期为152.6 pmol/L（灵敏度 = 92.5%，特异性 = 98.6%），FIGO IV期为203.8 pmol/L（灵敏度 = 81.8%，特异性 = 99.3%）。我们的研究结果表明HE4在EC分期预测中具有潜在作用。
