Department of Gynecology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuanjiagang, Yuzhong District, Chongqing, 400016, China.
Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, China.
Sci Rep. 2021 Nov 4;11(1):21694. doi: 10.1038/s41598-021-01263-w.
There is no recognized serum biomarker to predict the recurrence of endometrial carcinoma (EC). We aimed to explore serum human epididymis protein 4 (HE4) and cancer antigen 125 (CA125) as the biomarkers to predict and monitor recurrence of type II EC. 191 patients diagnosed with type II EC were involved for this retrospective study. Comparing recurrent with non-recurrent patients, HE4 levels resulted a statistically significant difference at primary diagnosis and recurrence, respectively (P = 0.002 and P = < 0.001), while CA125 levels resulted statistically significant (P = < 0.001) at recurrence. According to receiver operating characteristic curve analysis, the areas under the curve were significant for HE4 levels at primary diagnosis and recurrence predicting recurrence. Furthermore, CA125 levels at recurrence were significant. And the combination of both markers showed the higher sensitivity and specificity than single one. Patients with higher HE4 levels were associated with worse disease-free survival and overall survival, the opposite was true for patients with lower HE4 levels. The preoperative HE4 levels could be used to evaluate the risk factors of type II EC. Which suggested that HE4 levels might associated with the prognosis of type II EC. And combination of HE4 and CA125 could be applied to monitor recurrence during follow-up.
目前尚无公认的血清生物标志物可预测子宫内膜癌（EC）的复发。我们旨在探讨人附睾蛋白 4（HE4）和癌抗原 125（CA125）作为预测和监测 II 型 EC 复发的生物标志物。本回顾性研究纳入了 191 例确诊为 II 型 EC 的患者。与非复发患者相比，HE4 水平在初诊和复发时分别有统计学差异（P=0.002 和 P<0.001），而 CA125 水平在复发时也有统计学差异（P<0.001）。根据受试者工作特征曲线分析，HE4 水平在初诊和复发时预测复发的曲线下面积均有统计学意义。此外，CA125 水平在复发时也有统计学意义。并且两种标志物的联合显示出比单一标志物更高的敏感性和特异性。HE4 水平较高的患者无疾病生存和总生存较差，而 HE4 水平较低的患者则相反。术前 HE4 水平可用于评估 II 型 EC 的危险因素。这表明 HE4 水平可能与 II 型 EC 的预后相关。HE4 和 CA125 的联合应用可用于监测随访期间的复发。
