The Clinical Value Of Serum HE4 And CA125 In Endometrial Carcinoma

Objective:To evaluate the clinical value of preoperative serum HE4 and CA125 in endometrial carcinoma.Methods:Retrospective analysis of the preoperative levels of serum HE4 and CA125 in 150 cases of endometrial carcinoma（EC）patients,50 cases of endometrial atypical hyperplasia（AEH）patients and 50 cases of normal endometrium patients.The serum levels of HE4 and CA125 were compared in the case group and the control group,respectively.The differences of serum HE4 and CA125 between patients with EC stage I group（according to Figo,2009 endometrial carcinoma surgery and pathology）,atypical hyperplasia of endometrium group and normal endometrium group were compared.To draw the ROC curve of serum HE4 combined with CA125 level on EC extrauterine metastasis and calculate the area under the curve.The relationship between HE4 and CA125 and EC clinicopathological parameters was analyzed.Results:1.The serum HE4 was compared with the CA125 in the EC group,the endometrial atypical hyperplasia group and the normal endometrium group.ECgroupHE4:75.33pmol/L（60.41119.55）;CA125:23.48U/mL（14.33,45.86）.AEHgroupHE4:48.07pmol/L（43.23,60.54）;CA125:15.11U/mL（11.58,19.62）.NEgroup HE4:53.67pmol/L（47.23,61.52）;CA125:15.46U/mL（12.13,25.2）.The serum levels of HE4 and CA125 in the EC group were significantly higher than those in the AEH group and the control group,and the difference was statistically significant（P<0.001）.However,there was no significant difference in serum HE4 and CA125 levels between the AEH group and the control group,P>0.001(P_HE4=0.064,P_CA125=0.48).2.The serum HE4 was compared with the CA125 in the ECⅠgroup,the endometrial atypical hyperplasia group and the normal endometrium group.ECIphaseHE4:67.86pmol/L（56.08,80.37）;CA125:19.00（13.13,28.27）.AEHgroupHE4:48.07pmol/L（43.23,60.54）;CA125:15.11U/mL（11.58,19.62）.NE group HE4:53.67pmol/L（47.23,61.52）;CA125:15.46U/mL（12.13,25.2）.There was significant difference in serum HE4 level between ECⅠgroupvand AEH group and AEH group,P<0.001,but there was no significant difference in serum CA125 level between ECⅠgroup and AHE group,P>0.001.3.The ROC-AUC values of HE4 and CA125 were 0.760 and 0.636respectively for the detection of EC extrauterine metastasis.The combined detection was 0.809,and the combined detection of ROC-AUC was the largest,with statistically significant difference（P<0.01）.The sensitivity of HE4 was 82.1%and the specificity was 65.8%;The sensitivity of CA125 was70.2%and the specificity was 53.1%;The sensitivity of combination was91.8%and the specificity was 43.6%.The serum HE4 and CA125 levels in EC patients were related to clinical stage,differentiation degree,depth of myometrial invasion and extrauterine metastasis.The difference was statistically significant（P<0.01）.The level of serum HE4 was associated with the age of the patients（P<0.01）.Conclusion:The combination of serum CA125 and HE4 is more advantageous to single detection in the early diagnosis and the prediction of extrauterine metastasis of endometrial carcinoma.