Value of preoperative HE4 as predictor of advanced disease in endometrioid endometrial cancer

ABSTRACT Objective To explore the predictive value of serum human epididymis protein 4 (HE4) marker in the preoperative prediction of the risk of advanced disease in the endometrioid subtype of endometrial cancer, and its association with poor prognostic factors. In addition, a cut‐off value of HE4...

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Veröffentlicht in:International journal of gynecology and obstetrics 2021-04, Vol.153 (1), p.64-70
Hauptverfasser: Espiau Romera, Andrea, Coronado Martín, Pluvio Jesús, Chóliz Ezquerro, Marta, Cuesta Guardiola, Tatiana, Adiego Calvo, Ignacio, Baquedano Mainar, Laura
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Sprache:eng
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Zusammenfassung:ABSTRACT Objective To explore the predictive value of serum human epididymis protein 4 (HE4) marker in the preoperative prediction of the risk of advanced disease in the endometrioid subtype of endometrial cancer, and its association with poor prognostic factors. In addition, a cut‐off value of HE4 was defined to classify patients according to these results. Methods Prospective and multicenter cohort analytical pilot study of patients operated for endometrial cancer at the Miguel Servet University Hospital of Zaragoza (Spain) and the Complejo Universitario of León (Spain) from January 2017 to May 2019. Preoperative serum levels of HE4 were analyzed by clinical and pathologic characteristics. Results In all, 126 patients were included. A statistically significant association was found between the preoperative HE4 value and node involvement (P = 0.008), late‐stage disease (P = 0.003), high histologic grade (P = 0.007), deep myometrial invasion (P = 0.001), lymphovascular space invasion (P = 0.001), and other pathologic factors. In addition, an HE4 cut‐off value (156.4 pmol/L) has been determined to predict, preoperatively, which patients will present with early stage disease. Conclusions The preoperative marker HE4 is a useful tool in the preoperative study of patients with endometrial cancer as it relates to late‐stage disease as well as other prognostic factors in the endometrioid subtype of endometrial cancer. High preoperative values of HE4, especially higher than 156.4 pmol/L, seem to be associated with an advanced stage of disease in endometrioid endometrial cancer.
ISSN:0020-7292
1879-3479
DOI:10.1002/ijgo.13473