Chudecka-Głaz Anita, Strojna Aleksandra, Michalczyk Kaja, Wieder-Huszla Sylwia, Safranow Krzysztof, Skwirczyńska Edyta, Jurczak Anna
Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, 70-204 Szczecin, Poland.
Department of Clinical Nursing, Pomeranian Medical University, 71-210 Szczecin, Poland.
Diagnostics (Basel). 2023 Jan 26;13(3):452. doi: 10.3390/diagnostics13030452.
HE4 is a commonly used tumor marker for ovarian cancer (OC) diagnosis. In our study, we aimed to assess its use in the diagnosis of subsequent OC recurrences and to evaluate its changes during recurrence diagnosis and the subsequent lines of chemotherapy treatment. This retrospective single center study was conducted on 188 patients treated for ovarian cancer recurrence at the Department of Gynecological Surgery and Gynecological Oncology. The sensitivity and specificity of HE4 for patient survival prediction were analyzed using Receiver Operating Characteristics (ROC) and area under the curve (AUC) with 95% confidence intervals (95% CI). Survival times to reach one of the endpoints (OS, PFS, TFI, PFS2, TFI2) were analyzed using Kaplan-Meier curves. Elevated HE4 levels at the time of first relapse diagnosis, and after the third and the last course of second-line chemotherapy, significantly influences the time from OC diagnosis until first disease recurrence (PFS2) ( = 0.005, = 0.015 and = 0.002, respectively). Additionally, elevated serum HE4 concentration at the time of OC diagnosis ( = 0.012), and its later recurrence (first ( < 0.001), and second recurrent diagnosis ( = 0.143)) significantly influences patient OS. Increased HE4 concentration at the end of chemotherapeutic treatment negatively affects overall patient survival (( = 0.006 for second line chemotherapy and ( = 0.022) for elevated HE4 concentration after the last course of third-line chemotherapy). Our preliminary results show an encouraging diagnostic and prognostic role of HE4 in recurrent ovarian cancer. HE4 measurements at different treatment time points during the second- and third-line chemotherapy treatment seem to correlate with patient survival.
人附睾蛋白4（HE4）是一种常用于卵巢癌（OC）诊断的肿瘤标志物。在我们的研究中，我们旨在评估其在后续OC复发诊断中的应用，并评估其在复发诊断和后续化疗疗程中的变化。这项回顾性单中心研究对188例在妇科手术和妇科肿瘤学部门接受卵巢癌复发治疗的患者进行。使用受试者工作特征（ROC）和曲线下面积（AUC）以及95%置信区间（95%CI）分析HE4对患者生存预测的敏感性和特异性。使用Kaplan-Meier曲线分析达到终点之一（总生存期（OS）、无进展生存期（PFS）、首次复发时间（TFI）、第二次无进展生存期（PFS2）、第二次首次复发时间（TFI2））的生存时间。首次复发诊断时、二线化疗的第三个疗程和最后一个疗程后HE4水平升高，显著影响从OC诊断到首次疾病复发的时间（PFS2）（分别为P = 0.005、P = 0.015和P = 0.002）。此外，OC诊断时血清HE4浓度升高（P = 0.012）及其随后的复发（首次复发（P < 0.001）和第二次复发诊断（P = 0.143））显著影响患者的总生存期。化疗治疗结束时HE4浓度升高对患者总体生存有负面影响（二线化疗时P = 0.006，三线化疗最后一个疗程后HE4浓度升高时P = 0.022）。我们的初步结果显示HE4在复发性卵巢癌中具有令人鼓舞的诊断和预后作用。二线和三线化疗治疗期间不同治疗时间点的HE4测量似乎与患者生存相关。
