Crha Tomáš, Ovesná Petra, Weinberger Vít, Felsinger Michal, Babjak Branislav, Valík Dalibor, Hausnerová Jitka, Minář Luboš
Department of Gynecology and Obstetrics, University Hospital Brno and Faculty of Medicine, Masaryk University, 60200 Brno, Czech Republic.
Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic.
Cancers (Basel). 2025 Aug 23;17(17):2740. doi: 10.3390/cancers17172740.
: Endometrial carcinoma is the most common gynaecological malignant tumour in developed countries. At present, no routinely used serum biomarker is available for the prediction of lymph node metastasis (LNM). This study thus evaluates the potential of tumour markers CA125 and HE4 as LNM predictors in endometrial carcinoma patients. : The aim of this study was to evaluate the potential use of CA125 and HE4 and to assess the viability of a model developed using the parameters of serum tumour marker levels for LNM risk stratification. : A retrospective, single-institution study of 220 patients with biopsy-proven endometrial carcinoma was conducted from May 2020 to December 2023. Preoperative serum levels of HE4 and CA125 were determined. All patients underwent surgical lymph node staging. The study evaluated the sensitivity and specificity of tumour markers and of the developed LNM risk prediction model. : No LNM was observed in 167 of the 220 patients (75.9%), micrometastatic lymph node involvement was observed in 13 patients (5.9%), and macrometastatic involvement was observed in 24 patients (10.9%). Median CA125 and HE4 levels were significantly higher in patients with LNM than in those without. With a CA125 cut-off value of 35 IU/mL, a sensitivity of 70% and a specificity of 92% were obtained, while an HE4 cut-off value of 103 pmol/L yielded a sensitivity of 78% and a specificity of 80%. A prediction model combining CA125, HE4, and the extent of uterine invasion, as detected by ultrasound, yielded a sensitivity of 84% and a specificity of 98% in predicting LNM. : CA125 and HE4, along with the prediction model, facilitate endometrial carcinoma patient subdivision into low- and high-risk LNM groups. As this method is technically simple, non-invasive, and inexpensive, it could be of undeniable benefit in the risk stratification of patients with multiple comorbidities, which limit the duration and extent of surgery.
子宫内膜癌是发达国家最常见的妇科恶性肿瘤。目前，尚无常规使用的血清生物标志物可用于预测淋巴结转移（LNM）。因此，本研究评估了肿瘤标志物CA125和HE4作为子宫内膜癌患者LNM预测指标的潜力。
本研究的目的是评估CA125和HE4的潜在用途，并评估使用血清肿瘤标志物水平参数开发的模型对LNM进行风险分层的可行性。
对2020年5月至2023年12月期间220例经活检证实为子宫内膜癌的患者进行了一项单机构回顾性研究。测定术前血清HE4和CA125水平。所有患者均接受了手术淋巴结分期。该研究评估了肿瘤标志物及所开发的LNM风险预测模型的敏感性和特异性。
220例患者中，167例（75.9%）未观察到LNM，13例（5.9%）观察到微转移淋巴结受累，24例（10.9%）观察到宏转移受累。发生LNM的患者的CA125和HE4水平中位数显著高于未发生LNM的患者。CA125临界值为35 IU/mL时，敏感性为70%，特异性为92%；而HE4临界值为103 pmol/L时，敏感性为78%，特异性为80%。结合CA125、HE4以及超声检测到的子宫浸润程度构建的预测模型在预测LNM时，敏感性为84%，特异性为98%。
CA125、HE4以及该预测模型有助于将子宫内膜癌患者分为LNM低风险组和高风险组。由于该方法技术简单、无创且成本低廉，对于因多种合并症而限制手术时长和范围的患者进行风险分层具有不可忽视的益处。
