Department of Obstetrics and Gynecology, 65462Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea.
Cancer Control. 2022 Jan-Dec;29:10732748221097778. doi: 10.1177/10732748221097778.
The objective is to evaluate the prognostic value of serum human epididymis protein 4 (HE4) as a tumor marker in patients with cervical cancer.
Sixty-seven patients with cervical cancer treated at Seoul National University Bundang Hospital from September 2014 to May 2018 were retrospectively reviewed. Serum HE4 levels were measured by immunoassay before starting primary treatment. A mean serum HE4 level of 72.6 pmol/L was used to divide the patients into low and high HE4 groups. Patient characteristics, clinicopathological variables, and survival outcomes were compared between the two groups.
The low and high HE4 groups included 55 (82.1%) and 12 (17.9%) patients at diagnosis, respectively. Higher HE4 levels were significantly associated with older age at diagnosis (age <50: .0% vs age ≥50: 100.0%; P = .002), menopause (premenopause: 8.3% vs postmenopause: 91.7%; P = .009), higher FIGO stage (stage I-II: 33.3% vs III-IV: 66.7%; P = .017), large tumor size (<4.0 cm: 41.7% vs ≥4.0 cm: 58.3%; P = .029), positive lymph node metastasis (negative: 41.7% vs positive: 58.3%; P = .049), and involvement of the parametrium (negative: 25.0% vs positive: 75.0%; P = .002). Higher HE4 level was a predictive factor for worse overall survival but not for progression-free survival. Elevated HE4 levels were not independent factors for the prediction of either overall survival or progression-free survival. Subgroup analysis by histological type revealed similar results for patients with squamous cell carcinoma.
High levels of HE4 expression correlated with poor overall survival, indicating that elevated HE4 levels are associated with a poor prognosis for patients with cervical cancer.
评估血清人附睾蛋白 4（HE4）作为宫颈癌肿瘤标志物的预后价值。
回顾性分析 2014 年 9 月至 2018 年 5 月在首尔国立大学盆唐医院接受治疗的 67 例宫颈癌患者的临床资料。在开始初始治疗前，采用免疫分析法测定血清 HE4 水平。以 72.6pmol/L 的平均血清 HE4 水平将患者分为低 HE4 组和高 HE4 组。比较两组患者的特征、临床病理变量和生存结局。
低 HE4 组和高 HE4 组患者在诊断时分别为 55 例（82.1%）和 12 例（17.9%）。较高的 HE4 水平与诊断时年龄较大（<50 岁：0.0% vs. ≥50 岁：100.0%；P=0.002）、绝经状态（绝经前：8.3% vs. 绝经后：91.7%；P=0.009）、FIGO 分期较高（Ⅰ-Ⅱ期：33.3% vs. Ⅲ-Ⅳ期：66.7%；P=0.017）、肿瘤较大（<4.0cm：41.7% vs. ≥4.0cm：58.3%；P=0.029）、淋巴结转移阳性（阴性：41.7% vs. 阳性：58.3%；P=0.049）和宫旁组织受累（阴性：25.0% vs. 阳性：75.0%；P=0.002）相关。较高的 HE4 水平是总生存较差的预测因素，但不是无进展生存的预测因素。升高的 HE4 水平不是总生存或无进展生存预测的独立因素。根据组织学类型进行的亚组分析显示，在鳞状细胞癌患者中也有类似的结果。
高水平的 HE4 表达与总生存不良相关，表明升高的 HE4 水平与宫颈癌患者的不良预后相关。
