Abstract

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.

Highlights

  • There is no recognized serum biomarker to predict the recurrence of endometrial carcinoma (EC)

  • Overexpression in human epididymis protein 4 (HE4) and cancer antigen 125 (CA125) genes were found in EC patients through The Cancer Genome Atlas (TCGA) gene database and we found the significantly correlated with the overall survival of EC patients, which indicated that HE4 and CA125 were closely correlated with EC

  • According to Wilcoxon test, serum CA125 and HE4 are significantly related to clinical pathological risk factors at primary diagnosis, such as depth of myometrial invasion, lymph node status and Federation of Gynecology and Obstetrics (FIGO) stage

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Summary

Introduction

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. EC patients followed up by imaging techniques, such as computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET)[7]. These approaches were high expenditure and not handy. Current guidelines of the National Comprehensive Cancer Network (NCCN) point out, Patients with EC after initial treatment, who experience symptoms such as abnormal bleeding again or imaging suggests recurrence, commonly, tend to distant metastasis leading to poor results of treatment, in the l­iteratures[13], the early detection and comprehensive individual treatment of local recurrence, will guide a better prognosis

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