Abstract
Currently, no clinically useful tumor marker is available for primary diagnosis in endometrial cancer. Human epididymis protein-4 (HE-4) has high sensitivity and specificity as a tumor marker. Further, HE-4 has been shown to be elevated in early stage endometrial cancer and is more sensitive than CA 125. In our study, CA 125 and HE-4 reputation as a tumor marker for diagnosis of ovarian and endometrial cancer with the use of both the availability and affect the way we investigated the rate of diagnosis. Here 20 patients with ovarian cancer, 26 patients with endometrial cancer, which had been histologically diagnosed, and 40 healthy volunteers were included. Peripheral blood samples were taken and serum CA 125 and HE-4 were tested. Serum CA 125 and HE-4 levels in patients with ovarian cancer were found to be significantly higher than those in healthy volunteers (p<0.05). Receiver-operating characteristic (ROC) analysis was performed. For patients with ovarian cancer and healthy controls, the CA 125 (0.83) and HE-4 (0.84) levels showed increased sensitivity (95%). There was no significant difference in the CA 125 levels in patients with endometrial cancer and healthy controls (p>0.05), whereas HE-4 levels were found to be higher in patients with endometrial cancer than in healthy controls (p<0.05). ROC analysis was performed. For endometrial cancer patients and healthy controls, the CA 125 (0.59) and HE-4 (0.63) levels showed increased sensitivity (88.5%). In ovarian and endometrial cancer, wherein early diagnosis is the most important factor for prognosis and survival, HE-4 is a new serum tumor marker that can be used with the aim of noninvasive diagnoses. For early diagnosis, the concomitant use of CA 125 and HE-4 is more effective and reliable than using either of them alone.
Highlights
It is known that a prognosis will be poor and survey rates will be lower if endometrial cancer, similar to ovarian cancer, is diagnosed at a later stage [1]
For patients with ovarian cancer and healthy controls, the CA 125 (0.83) and Human epididymis protein-4 (HE-4) (0.84) levels showed increased sensitivity (95%)
There was no significant difference in the CA 125 levels in patients with endometrial cancer and healthy controls (p>0.05), whereas HE-4 levels were found to be higher in patients with endometrial cancer than in healthy controls (p
Summary
It is known that a prognosis will be poor and survey rates will be lower if endometrial cancer, similar to ovarian cancer, is diagnosed at a later stage [1]. As ovarian cancer symptoms are nonspecific, a distinctive diagnosis is based, in general, on the viewing techniques and preoperative serum tumor markers [2]. The ideal tumor marker needs to have high sensitivity and specificity for the distinction of patients with cancers and benign diseases as well as healthy controls [3]. Serum CA 125 is suitable for the diagnosis of advanced phase ovarian cancers, but there are no reliable serum biomarkers that can be clinically used for the diagnosis of endometrial cancer [4]. Our study researched the usability of HE-4, a non-marker, for endometrial and ovarian cancers. It has been recognized as a noninvasive method in terms of its significance during early diagnosis of cancers, both singly or in combination with CA 125
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