Wang Yingmei, Han Cha, Teng Fei, Bai Zhaoyi, Tian Wenyan, Xue Fengxia
Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, Tianjin, China.
Int J Gynaecol Obstet. 2017 Jan;136(1):58-63. doi: 10.1002/ijgo.12010. Epub 2016 Nov 3.
To evaluate the predictive value of serum HE4 and CA125 concentrations in the preoperative prediction of risk of lymph node metastasis in endometrial cancer.
A retrospective study was undertaken of data for patients with endometrial carcinoma treated surgically at a university hospital in China between August 2011 and December 2015. The preoperative serum levels of HE4 and CA125 were measured and analyzed by clinicopathologic characteristics.
Overall, 258 patients were included. The HE4 and CA125 concentrations were significantly elevated in patients with large lesions (≥2 cm), deep myometrial invasion (≥50%), an advanced disease stage, or lymph node metastasis (P<0.05 for all). HE4 concentrations also rose with age and histologic grade (P<0.01 for both). For lymph node metastasis, HE4 had higher sensitivity and negative predictive value than did CA125. The diagnostic performance of HE4 and CA125 in combination was superior to that of either marker alone.
The combined evaluation of serum HE4 and CA125 could provide gynecologic oncologists with improved information to guide the decision of whether to perform lymphadenectomy.
评估血清HE4和CA125浓度在子宫内膜癌术前预测淋巴结转移风险中的预测价值。
对2011年8月至2015年12月在中国某大学医院接受手术治疗的子宫内膜癌患者的数据进行回顾性研究。通过临床病理特征对术前血清HE4和CA125水平进行测量和分析。
共纳入258例患者。在病变较大（≥2 cm）、肌层浸润较深（≥50%）、疾病分期较晚或有淋巴结转移的患者中，HE4和CA125浓度显著升高（所有P<0.05）。HE4浓度也随年龄和组织学分级升高（两者P均<0.01）。对于淋巴结转移，HE4的敏感性和阴性预测值高于CA125。HE4和CA125联合检测的诊断效能优于单一标志物。
血清HE4和CA125联合评估可为妇科肿瘤学家提供更多信息，以指导是否进行淋巴结清扫术的决策。
