Abstract
Objective:To investigate the clinical significance of human epididymal secretory protein E4 (HE4) in combination with cancer antigen 125 (CA125) in the diagnosis of endometrial cancer.Methods:One hundred and fifty patients with endometrial cancer who were admitted to Binzhou People’s Hospital, Shandong, China, between June 2013 and July 2014, were enrolled and set as an endometrial cancer group; another one hundred patients with benign uterine diseases and one hundred healthy females were also enrolled. The serum was collected from the subjects for the detection of HE4 level. The level of CA125 was detected using electrochemiluminescence assay (ELISA). Receiver Operating Characteristic (ROC) curve was drawn to analyze the cutoff points of HE4 and CA125 levels for the diagnosis of endometrial cancer. The diagnostic efficacy based on the detection of the two indexes separately and jointly was evaluated.Results:The area under curve (AUC) for diagnosis of endometrial cancer based on HE4 was superior to that based on CA125 (0.819 vs 0.757). The optimal diagnosis cutoff point of HE4 and CA125 on the ROC curves was 92.21 pmol/L and 31.32KU/L, respectively. The sensitivity, Youden index, coincidence rate and negative predicted value of diagnosing endometrial cancer with HE4 in combination with CA125 (73.2%, 0.641, 83.5% and 83.4%) were significantly higher than those of diagnosing endometrial cancer with the two indexes separately. The ROC-AUC value of serum HE4 and CA125 was 0.749 and 0.528 respectively, much lower than that of HE4 in combination with CA125 (0.794; P<0.05).Conclusion:Serum HE4 and CA125 are the ideal marker combination for the diagnosis of endometrial cancer. HE4 combined with CA125 is beneficial to the diagnosis of endometrial cancer; hence it is worth promotion in clinical practice.
Highlights
Endometrial cancer, one of the most commonly seen malignant tumors in female reproductive tract, histologically originates from endometrial glands.[1]
Analysis of Receiver Operating Characteristic (ROC) curves of diagnosis of endometrial cancer based on human epididymal secretory protein E4 (HE4) and cancer antigen 125 (CA125): The subjects in the benign uterine diseases group and healthy control group were determined as negative, while the patients in the malignant group were determined as positive
ROC curves were drawn for the diagnostic sensitivity and specificity of endometrial cancer based on different cutoff points of HE4 and CA125 (Fig.1)
Summary
Endometrial cancer, one of the most commonly seen malignant tumors in female reproductive tract, histologically originates from endometrial glands.[1]. Diagnostic curettage and imaging are the major methods for diagnosing endometrial cancer; they had indistinctive advantages and cannot screen population with risks through general investigation.[5] The promotion of tumor markers in the early diagnosis of clinical malignant tumors makes the early diagnosis of endometrial cancer possible.[6] Serum cancer antigen 125 (CA125), a kind of high-molecular-weight protein expressed in coelomic epithelium in embryonic development, has been extensively applied for the diagnosis and monitoring of malignant tumors in organs such as ovary, mammary gland, digestive tract and respiratory tract; it is the most commonly used tumor marker for the diagnosis of ovarian cancer currently. Our objective was to study the feasibility and accuracy of HE4 and CA125 as the markers of the diagnosis of endometrial cancer of patients especially high risk patients, this study retrospectively analyzed the levels of HE4 and CA125 of 150 patients with endometrial cancer
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