The diagnostic value of human epididymis protein 4 for endometrial cancer is moderate

Jing Liu,Lili Han,Zhen Jiao

doi:10.1038/s41598-020-79960-1

Jing Liu, Lili Han + Show 1 more

Open Access

https://doi.org/10.1038/s41598-020-79960-1

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Abstract

Human epididymis protein 4 (HE4) has been used as a biomarker of endometrial cancer (EC) in clinical practice. However, there remains a lack of systemic research on the critical values of HE4 for diagnosing different clinical stages and pathological types of EC. This study investigated the accuracy of human epididymis protein 4 (HE4) in the diagnosis of EC. Patients who were hospitalized for a chief complaint of abnormal vaginal hemorrhage at Xinjiang Uyghur Autonomous Region People's Hospital between 2014 and 2019 were consecutively included. Pathological biopsy confirmed the diagnosis of EC; there were a total of 136 EC patients and 127 non-EC patients. The accuracy of HE4 in the diagnosis of EC was assessed with SPSS software. The accuracy of HE4 for diagnosing different clinical stages and pathological types of EC was also explored. The critical value of HE4 for endometrial cancer was 52.40 mmol/L, with a sensitivity of 57.35% and a specificity of 76.38%. For different stages of EC, the critical value was 36.9 mmol/L, and the sensitivity and specificity were 28% and 87.39%, respectively. For different pathological types, the critical value was 30.60 mmol/L, and the sensitivity and specificity were 93.85% and 33.33%, respectively. The diagnostic value of HE4 for EC is moderate, and the serum HE4 level cannot reflect the stage and type of EC.

Highlights

Human epididymis protein 4 (HE4) has been used as a biomarker of endometrial cancer (EC) in clinical practice
According to a meta-analysis[21], studies on the use of serum human epididymis protein 4 (HE4) for diagnosing EC have the following drawbacks: (1) most of the reported studies suffered from a sample selection bias, which artificially increased the sensitivity and specificity of HE4 in diagnosing EC; and 2) there remains a lack of systemic research on the critical values of HE4 for diagnosing different clinical stages and pathological types of EC
The diagnostic value of serum HE4 for EC was systemically investigated based on the suspected case inclusion method

Summary

Introduction

Human epididymis protein 4 (HE4) has been used as a biomarker of endometrial cancer (EC) in clinical practice. Scholars and researchers have proposed different methods for early EC screening, such as hysteroscopy (HS)8, ultrasound[9], endometrial cytology testing[10], magnetic resonance imaging (MRI)[11] and tumor marker d etection[12] Among these methods, HS combined with fractional curettage is the most frequently used method for early EC screening because of its relatively high diagnostic accuracy. According to a meta-analysis[21], studies on the use of serum HE4 for diagnosing EC have the following drawbacks: (1) most of the reported studies suffered from a sample selection bias, which artificially increased the sensitivity and specificity of HE4 in diagnosing EC; and 2) there remains a lack of systemic research on the critical values of HE4 for diagnosing different clinical stages and pathological types of EC

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