The assessment of usefulness of HE4 and CA125 quantification for the diagnostics of endometrial cancer

Abstract

Endometrial cancer is one of the most prevalent uterine malignancies. This disease occurs mostly in older women, frequently affected with other comorbidities. Hence, it is important to search for novel, less burdensome diagnostic modalities, enabling the objective assessment of the patient’s status and facilitating qualification to relevant risk groups prior to surgical treatment. The aim of this study was to verify the usefulness of CA125 and HE4 in the evaluation of endometrial cancer. The study included 308 women treated at University Hospital No. 2 in Bydgoszcz. The study group included 180 patients operated due to endometrial cancer. The control group included 128 women operated due to perineal statics disorders. The concentrations of tumour markers were measured with ELISA-based ready-to-use diagnostic kits. Patients with endometrial cancer and healthy women differed significantly in terms of HE4 concentrations (P = 0.001). The serum concentration of HE4 in stage I endometrial cancer patients was significantly higher (Me = 88.37 pM) than in healthy women (Me = 46.14) (P = 0.007). The analysis of ROC curves with the determination of the area under curve showed 66.7% sensitivity and 78.1% specificity of HE4. AUC for HE4 amounted to 0.721 and was the highest of all markers. Our analysis revealed that HE4 is useful in the detection of endometrial cancer, while Human Epididymis Protein 4 can potentially be used for screening purposes. CA125 antigen, previously used in the diagnostic process, is useless or may possess limited usefulness. There is a need for further studies on larger populations of female patients.