|The Utility of CA 125 and HE 4 in Patients Suffering From Endometrial Cancer|
|Zamani Narges1, ModaresGilani Mitra2, Mirmohammadkhani Majid3, Sheikhhasani Sharzad2, Azamsadat Mousavi2, Yousefi Sharamiseyedeh Reyhaneh4, Setare Akhavan2, Zamani Mohammad Hossein1, Saffarieh Elham5|
|1Department of Gynecology and Obstetrics, Emam Hospital complex, Tehran University of Medical Sciences, Tehran, Iran
2Department of Oncologic Gynecology, Vali-Asr hospital, Tehran University of Medical Sciences, Tehran, Iran
3Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
4Department of Obstetrics and Gynecology, faculty of medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
5Abnormal Uterine Bleeding Research Center, Semnan University of Medical Sciences, Semnan, Iran.
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Keywords : Endometrial cancer, Human epididymis, Cancer Antigen 125
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Objectives :Uterine Endometrial cancer is the most common female reproductive system malignancy.There are various comments on Pelvic and para-aortic lymphadenectomy during the surgical staging of endometrial cancer. Several oncologists believe that total lymphadenectomy, in some cases, may lead to operative morbidity without any considerable advantage over more surveillance,especially in patients with comorbidities. The purpose of current study is to examine the correlation between serum tumor markers level and stages, grade, histological type, myometrial invasion and lymph nodes involvement.
Materials and Methods: A number of 131 people with E,C participated in the present cross sectional study. preoperative serum CA125 and HE4 levels were evaluated a week before surgery.Then,the stage,grade and lymph nodes involvement were recorded according to the pathological findings.After Data analysis through spss software, P value<0.05 was considered to be significant.
Results: 131 patients with endometrial cancer (70, 31, 15 and 15 patients in sequence with stage IA, IB, II,III) were analyzed. The serum CA125 and HE4 levels were significantly higher in more advanced stages(over IA),(p=0.016 and p=0.004 respectively). Both of tumor markers levels were significantly higher in patients with lymph nodes involvement, cervical and myometrial invasion. In logistic regression analysis, significant correlation between HE4 (OR=1.005, P=0.035) and grade (OR=2.137, P=0.005) was identified.
Conclusion: HE4 and CA125 are useful for predicting high-risk patients. sensitivity of 64% and specificity of 60% were indicated at cut-off value of 70 pmol/l for HE4 in stage IA in comparison with stages over IA. Although the ideal cut-off which is defined as higher than 80% was not obtained, such a cut-off (60%)can also be considerable for preoperative evaluation of endometrial cancer surgical staging.
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