Research On The Relationship Between Serum HE4 And Prognosis Of Epithelial Ovarian Cancer

ObjectiveThis study aimed to analyze the significance of human epididymis protein 4(HE4)on recurrence of epithelial ovarian cancer(EOC),platinum-resistance,tumor stage and radical cytoreductive surgery,and investigate HE4 clinical value as a role of indicator for EOC prognosis prediction.MethodsIn our study,56 cases were completely collected and retrospectively analyzed,of which all had received surgery and platinum-based chemotherapy for EOC in Tianjin First Central Hospital from January 2014 to December 2017.According to clinicalpathological traits,all the cases were divided into several different groups,including recurrence and non-recurrence groups,early-stage and late-stage groups,satisfiedoperation and dissatisfied-operation groups,as well as,platinum-resistance and platinum-sensitivity groups,so as to evaluate importance of HE4,CA125 and ROMA in EOC.What’s more,all the cases were separated into two clasified groups,high-level and low-level groups,based on HE4,CA125 and ROMA count in recurrence group.Items,including sensitivity,specificity,positive predict value(PPV)and negative predict value(NPV),were compared separately to explore HE4 clinical worth on the prediction of EOC prognosis.Results1.In all the EOC patients,the rate of recurrence was 28.6%(15/56),with all EOCⅢ stage(15/15).2.In recurrence and nonrecurrence groups,HE4 medians were 372.7(171.4,608.7)pmol/L and 155.3(68,361.6)pmol/L(U=183.0,P=0.021);CA125 medians were 638,6(39.1,2335)U/ml and 184.1(50.8,693.3)U/ml(U=221.0,P=0.11);ROMA medians were 97.4(54,98.8)% and 57.2(18.9,92.7)%(U=176.5,P=0.015).HE4 level in late-stage was higher than that in early-stage [367.5(154.6,523.8)pmol/L vs 87.7(63.5,234.1)pmol/ L,U=176.0,P=0.000].CA125 and ROMA levels in late-stage,which were 541.3(156.8,2040.5)U/ml and 90.8(62,92.7)%,were higher than the early-stage’s,as in 74.9(32.2,235.9)U/ml and 30.7(13.7,83.1)%(U=185.0vs172.0,P=0.001vs0.000).For dissatisfied-operation group,medians of HE4,CA125 & ROMA were 453.2(367.5,1071.5)pmol/L,1805(472.5,2138.5)U/ml &97.6(92.4,99)%,which were far more valuable than that in the counterpart[(U=478.0.P=0.000);(U=185.0,P=0.001);(U= 72.0,P=0.000)].As for platinum-resistance and platinum-sensitivity groups,numbers of HE4,CA125 & ROMA were 372.8(181,8,768.9)pmol/L and169.1(69,0,395.4)pmol/L,487.4(40.8,3677.7)U/ml and 187.6(48.7,844.5)U/ml,92.5(56.6,99.0)% and 73(22.2,96)%,which had statistical compassion[(U=106.5,P=0.044),(U=185.0,P= 0.001),(U=117.5,P=0.081)].3.By using HE4 median in recurrence group(≥370pmol/L)as cut-off value,the SEN,SPE,PPV and NPV of prediction were 47.1%,82.1%,53.3% and 78.0% for recurrence;88.2%,61.5%,50% and 92.3% for late-stage;58.8%,92.3%,76.9%,83.7% for dissatisfied-operation;23.5%,89.7%,50% and 72.9% for platinum-resistance,respectively.As for CA125(≥640U/ml),the SEN,SPE,PPV and NPV of prediction were 41.2%,79.5%,46.7% and 75.6% for recurrence;82.4%,59.0%,46.7%,88.5% for late-stage;52.9%,89.7%,69.2%,81.4% for dissatisfied-operation;17.6%,87.2%,37.5%,70.8% for platinum-resistance,respectively.As for ROMA(≥97%),the SEN,SPE,PPV and NPV of prediction were 57.1%,83.3%,53.3% and 85.4% for recurrence;92.8%,59.5%,43.3%,96.2% for late-stage;71.4%,92.8%,76.9%,90.7% for dissatisfied-operation;28.6%,90.5%,50% and 79.2% for platinum-resistance.Conclusions1.Preoperative serum HE4 is associated with ovarian cancer recurrence and platinum-resistance.The higher HE4 level is,the more risk EOC recurrence and the worse platinum sensitivity is.2.Preoperative high HE4 level indicates tumor’s late stage and likehood of tumor residual caused by half-way surgery.3.In terms of EOC recurrence,stage,radical operation and platinum resistance,HE4 and ROMA can be as indicators for worse outcome because of satisfying SEN & SPE.