Tumor Markers in Endometrial Cancer

Abstract

The purpose of this review is to update readers on recent findings about serum tumor markers in clinical settings of endometrial cancer. The latest research on this topic discussed risk factors of pelvic lymph node metastasis and levels of two serum tumor markers (human epididymis protein 4 and cancer antigen 125; HE4, CA-125) preoperatively in the patients with endometrial cancer. This study showed that higher preoperative laboratory results of human epididymis protein 4 and CA-125 are independent risk factors for pelvic lymph node metastasis in endometrial cancer patients. Based on this research, lymphadenectomy is not recommended if none of independent risk factors is present. Prevention of unnecessary lymph node resection and complications associated with lymphadenectomy for low-risk patients is made possible. The authors suggested more effective predictors of lymph node metastasis should be investigated to provide theoretical support for deciding lymphadenectomy and guide the individualized endometrial cancer care. Evaluation of the endometrium with invasive procedures is the only method to determine endometrial cancer. Tumor markers are used for the initial diagnosis of the disease, determining risk stratification and prognosis. For now, there is no ideal marker identified for endometrial cancer. With recent progresses in molecular biology, the mechanisms underlying endometrial cancer have been understood gradually. Thus, several investigations have been carried out to find new candidate biomarkers in the last decade. Human epididymis protein 4 is shown to have a good performance for clinical use as a prognostic factor in endometrial cancer. However, further large prospective randomized trials are needed to confirm the prognostic role of it. The use of ideal tumor marker for endometrial cancer will permit earlier detection of disease and better prognostic assessment and improve the patient’s outcome.