|The Importance of HE4 and CA 125 in Overall Survival and Recurrence-free Survival of Endometrial Cancer|
|Mitra Modares Gilani1, Sedigheh Ghasemian Dizaj Mehr2, Azamsadat Mousavi1, Setare Akhavan1, Sharzad Sheikhhasani1, Narges Zamani3, Leyla Sahebi4|
|1Department of Oncologic Gynecology, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
2Department of Obstetrics and Gynecology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
3Department of Gynecology and Obstetrics, Imam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
4Family Health Research Institute, Maternal-Fetal and Neonatal Research Center, Tehran University of Medical Science, Tehran, Iran
IJWHR 2022; 10: 086-090
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Keywords : Endometrial carcinoma, CA 125 antigen, HE4 protein, Overall survival, Recurrence-free survival
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Objectives: The present study aimed to assess the significance of human epididymis protein 4 (HE4) and cancer antigen 125 (CA 125) in the overall survival (OS) and the recurrence survival of endometrial cancer.
Materials and Methods: The study was conducted on 99 patients with a mean age of 53±64. The patients were all cases with a definitive diagnosis of endometrial cancer. With regard to the histology and the surface measurement, the HE4 and CA 125 were both confirmed within 1 to 2 week(s) prior to hysterectomy by implementing the standard-procedure treatment of extra facial total hysterectomy and bilateral salpingo-oophorectomy with selective pelvic and para-aortic node dissection. Then, risk-assessment for possible recurrence (Mayo criteria) was carried out as well. Patients with the variables of HE4 and CA 125 in the upper third (66th) percentiles were grouped as high-risk. Finally, the data were analyzed using SPPS 23, and P <0.05 was considered statistically significant.
Results: The mean (SE) of OS among patients with the serum CA 125 of ≤22 kU/L and higher 22 kU/L was 47.97 (±2.58) and 41.78 (3.75) months (P = 0.466). In addition, the mean (SE) of OS in patients with the serum HE4 level of ≤ 98 ρmol/L and >98 ρmol/L was 50.14 (2.06) and 38.54 (3.74), respectively. The log-rank test revealed a substantial difference between low- and high-risk groups by HE4 (χ2=4.98, P = 0.025). Accordingly, there is no significant difference between recurrence-free survival (RFS) with CA 125 (P = 0.264) and HE4 (P = 0.114), respectively.
Conclusions: In general, the serum HE4 level is a significant independent prognostic factor for OS in endometrial cancer and is useful in survival studies.
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