Cuesta-Guardiola Tatiana, Carretero Alicia Quiros, Martinez-Martinez Javier, Cuñarro-López Yolanda, Pereira-Sánchez Augusto, Fernández-Corona Alfonso, de Leon-Luis Juan Antonio
Department Obstetrics and Gynecology, Hospital of Leon, Leon, Spain
Department of Mathematics, University of Leon, Leon, Spain
J Turk Ger Gynecol Assoc. 2021 Aug 31;22(3):161-167. doi: 10.4274/jtgga.galenos.2021.2020.0120. Epub 2021 Jun 8.
Diagnosis of endometrial cancer (EC) is made by biopsy sampling with pathological analysis, but it is extremely important to make an accurate diagnosis in order to plan the specific treatment. We hypothesized that human epididymis protein 4 (HE4) in endometrial tissue and in serum could be beneficial for a more precise diagnosis.
This prospective study compared patients with EC against non- EC, matched through several variables. The inclusion criteria were: females older than 18 years who accepted to participate; who had never undergone surgery for other oncological pathologies (ovarian, colon, cervical carcinoma or uterine sarcoma); none of them had received preoperative chemo- or radio-therapy; and no participant had any severe renal or liver pathology. All had pre-surgery blood sampling and then underwent hysterectomy. Histopathological assessment of endometrial samples was made by a pathologist who compared normal histopathological staining with HE4-antibody staining.
In total there were 34 cases and 35 controls recruited. There was poor correlation between tissue HE4 in patients with and without carcinoma. However, serum HE4 was significant for the diagnosis of endometrial carcinoma (median EC: 123.1 U, median NE: 64.67 U, p=0.002), although the carbohydrate antigen 125 level was not significant (p=0.208).
The findings concerning the utility of HE4 contrast with earlier reports. However, the conclusions for serum measurements are positive and suggest that the tumor marker HE4 seems to be able to diagnose EC.
子宫内膜癌（EC）的诊断通过活检取样及病理分析来进行，但为了规划具体治疗方案，准确诊断极为重要。我们推测子宫内膜组织和血清中的人附睾蛋白4（HE4）可能有助于更精确的诊断。
这项前瞻性研究将EC患者与通过多个变量匹配的非EC患者进行了比较。纳入标准为：年龄超过18岁且同意参与的女性；从未因其他肿瘤性疾病（卵巢癌、结肠癌、宫颈癌或子宫肉瘤）接受过手术；均未接受术前化疗或放疗；且无参与者患有任何严重的肾脏或肝脏疾病。所有患者均在术前采集血样，然后接受子宫切除术。由病理学家对子宫内膜样本进行组织病理学评估，其将正常组织病理学染色与HE4抗体染色进行比较。
总共招募了34例病例和35例对照。有癌和无癌患者的组织HE4之间相关性较差。然而，血清HE4对子宫内膜癌的诊断具有显著意义（EC中位数：123.1 U，非EC中位数：64.67 U，p = 0.002），尽管糖类抗原125水平无显著意义（p = 0.208）。
关于HE4效用的研究结果与早期报告不同。然而，血清检测的结论是积极的，表明肿瘤标志物HE4似乎能够诊断EC。
