Plotti Francesco, Guzzo Federica, Schirò Teresa, Terranova Corrado, De Cicco Nardone Carlo, Montera Roberto, Luvero Daniela, Scaletta Giuseppe, Lopez Salvatore, Capriglione Stella, Benedetti Panici Pierluigi, Angioli Roberto
Università Campus Bio-Medico di Roma Facolta di Medicina e Chirurgia, Roma, Italy.
Università Campus Bio-Medico di Roma Facolta di Medicina e Chirurgia, Roma, Italy
Int J Gynecol Cancer. 2019 May 7;29(4):768-771. doi: 10.1136/ijgc-2019-000211.
There are no current guidelines regarding evaluation of patients with normal CA125 at initial diagnosis during routine surveillance after completion of treatment. Thus, the purpose of this study was to evaluate the role of human epididymis protein 4 (HE4) in the detection of recurrence in patients with ovarian cancer and a negative CA125 at diagnosis.
All patients with ovarian cancer with a negative CA125 referred to the Division of Gynecologic Oncology of the University Campus Bio-Medico of Rome were included in the study. Inclusion criteria were: age between 18 and 70 years old, diagnosis of epithelial ovarian cancer, optimal primary surgery (residual tumor <1 cm), and normal CA125 at initial diagnosis. Patients with other malignancies or chronic diseases were excluded from the study. Statistical analysis was based on the calculation of percentages, means, medians, and ranges of the values.
A total of eight patients were included in the study. The median age was 53 years (range 40-75). All patients had a normal CA125 at initial diagnosis while seven (87.5%) patients had abnormal HE4 levels at diagnosis. The International Federation of Gynecology and Obstetrics (FIGO) stages at enrollment varied from IC to IIIC (IB (1), IC (3), IIC (1), IIIC (3)). The most common histologic subtype was serous (62.5%). Seven patients recurred and had abnormal HE4 and normal CA125 values. The median HE4 at recurrence was 107 pmol/L. The median disease-free interval was 55 months (range 5-108) and all the patients underwent optimal cytoreductive surgery.
HE4 levels may serve as a marker for recurrence in patients with a normal CA125 at initial diagnosis. Future studies are needed to evaluate the role of HE4 levels in earlier detection of recurrent ovarian cancer.
目前尚无关于在治疗结束后的常规监测中对初始诊断时CA125正常的患者进行评估的指南。因此，本研究的目的是评估人附睾蛋白4（HE4）在诊断时CA125阴性的卵巢癌患者复发检测中的作用。
本研究纳入了所有转诊至罗马生物医学大学校园妇科肿瘤学部门且CA125阴性的卵巢癌患者。纳入标准为：年龄在18至70岁之间，上皮性卵巢癌诊断，最佳初次手术（残留肿瘤<1 cm），以及初始诊断时CA125正常。患有其他恶性肿瘤或慢性疾病的患者被排除在研究之外。统计分析基于对数值的百分比、均值、中位数和范围的计算。
共有8名患者纳入本研究。中位年龄为53岁（范围40 - 75岁）。所有患者在初始诊断时CA125均正常，而7名（87.5%）患者在诊断时HE4水平异常。入组时国际妇产科联盟（FIGO）分期从IC到IIIC不等（IB（1例），IC（3例），IIC（1例），IIIC（3例））。最常见的组织学亚型是浆液性（62.5%）。7名患者复发，其HE4异常而CA125正常。复发时HE4的中位数为107 pmol/L。无病生存期的中位数为55个月（范围5 - 108个月），所有患者均接受了最佳的细胞减灭术。
HE4水平可作为初始诊断时CA125正常的患者复发的标志物。未来需要开展研究以评估HE４水平在早期检测复发性卵巢癌中的作用。
