Yılmaz Setenay Arzu, Altınkaya Sündüz Özlem, Kerimoglu Özlem Seçilmiş, Tazegül Pekin Aybike, Akyürek Fikret, Ilhan Tolgay Tuyan, Benzer Nilgün, Unlu Ali, Yuksel Hasan, Celik Cetin
a Department of Gynecology & Obstetrics , Selçuk University Faculty of Medicine , Konya , Turkey.
b Department of Gynecology & Obstetrics , Faculty of Adnan Menderes University , Aydın , Turkey.
J Obstet Gynaecol. 2017 Jan;37(1):58-63. doi: 10.3109/01443615.2016.1174199. Epub 2016 Dec 22.
We evaluated the concentrations of human epididymis secretory protein E4 (HE4) and Ca-125 in relation to clinicopathologic features in patients with endometrial cancer and premalignant endometrial lesions. Women with abnormal uterine bleeding (n = 167) who underwent endometrial sampling were divided into four groups. Group 1: endometrial cancer (n = 68), group 2: atypical endometrial hyperplasia (n = 12), group 3: endometrial hyperplasia without atypia (n = 39) and group 4: controls (n = 48). Women with endometrial cancer exhibited higher concentrations of HE4 levels than controls (91.4 pmol/L vs. 46.2 pmol/L, p < 0.001). HE4 levels were significantly higher in patients with lymphatic involvement, deep myometrial invasion, lymphovascular space involvement and non-endometrioid histology (p < 0.001). The sensitivity, specificity, positive and negative predictive values for HE4 in detecting endometrial cancer were 72.7%, 84.4%, 80% and 78.4%, respectively. Preoperative HE4 levels are more elevated in women with endometrial cancer than those with benign endometrium as well as in women with prognostic high-risk factors with endometrial cancer. HE4 may be used as an additional marker in combination with other clinicopathologic features for planning the treatment.
我们评估了子宫内膜癌及癌前子宫内膜病变患者中人类附睾分泌蛋白E4（HE4）和Ca-125的浓度与临床病理特征的关系。对因异常子宫出血而接受子宫内膜取样的167名女性进行分组。第1组：子宫内膜癌（n = 68），第2组：非典型子宫内膜增生（n = 12），第3组：无异型性的子宫内膜增生（n = 39），第4组：对照组（n = 48）。子宫内膜癌女性的HE4水平高于对照组（91.4 pmol/L对46.2 pmol/L，p < 0.001）。有淋巴受累、肌层深部浸润、淋巴管间隙受累及非子宫内膜样组织学类型的患者HE4水平显著更高（p < 0.001）。HE4检测子宫内膜癌的敏感性、特异性、阳性预测值和阴性预测值分别为72.7%、84.4%、80%和78.4%。子宫内膜癌女性术前的HE4水平高于良性子宫内膜女性以及有子宫内膜癌预后高危因素的女性。HE4可作为一种辅助标志物，结合其他临床病理特征用于制定治疗方案。
