The Prognostic Value Of Preoperative Serum HE4 In Endometrial Carcinoma Patients

Objective Through the detection preoperative serum human epididymis secretory protein 4(HE4) and carbohydrate antigen 125(CA125) levels of endometrial cancer patients, analysising the relationships between the two tumor marks and survival, to investigate the relationship between serum HE4, CA125 and determination of value for predicting the prognosis of EC.Methods ELISA and MEIA methods were used to detect the serum HE4 and CA125 levels in 228 patients with EC in General Hospital Affiliated to Tianjin Medical University from January 2011 to December 2014, and the clinical, pathological and follow-up data were collected. Using Spearman rank correlation test to compare the relationship between HE4 and CA125 levels and EC patients’ age, using Cox’s proportional hazard regression model to analysis the relationship between a variety of clinical and pathological features, preoperative serum HE4 and CA125 levels and EC prognosis.Results1. Preoperative serum HE4 level was positively correlated with age and preoperative serum CA125 level in patients with endometrial cancer(correlation coefficients were 0.327 and 0.191, respectively, P < 0.05).2.Univariate survival analysis showed that Age≥60 years old, special pathological types, FIGO late stage(stage III and IV), myometrial invasion depth ≥1/2, lesions larger than 2 cm in diameter, lymph node metastasis positive, preoperative serum HE4 concentrations≥67.4 pmol/L and preoperative serum CA125 level≥13.4U/m L were significantly correlated with EC patients’ shorter overall survival(P < 0.05), menopause, waist to hip ratio≥0.8, BMI≥28kg/m2, with hypertension, with diabetes, low differentiation, cervical stromal invasion, with uterine isthmus involvement and adnexa metastasis were negatively related with EC patients’ shorter overall survival(P > 0.05).3.Multivariate survival analysis showed that Age≥60 years old, special pathological types, FIGO late stage(stage III and IV), myometrial invasion depth ≥1/2, cervical stromal invasion, lymph node metastasis positive, preoperative serum HE4 concentrations≥67.4 pmol/L and preoperative serum CA125 level≥13.4U/m L were significantly correlated with EC patients’ shorter disease free survival(P < 0.05), menopause, waist to hip ratio≥0.8, BMI≥28kg/m2, with hypertension, with diabetes, low differentiation, with uterine isthmus involvement,lesions larger than 2 cm in diameter, and adnexa metastasis were negatively related with EC patients’ shorter disease free survival(P > 0.05).Conclusion1. There was a positive correlation between preoperative serum HE4 and CA125 levels in patients with EC, suggesting that they may have a synergistic effect in the progression of EC.2. The risk of postoperative death in EC patients with the level of preoperative serum HE4≥67.4pmol/L was 4.042 times for this HE4’s level<67.4pmol/L, and the risk of postoperative recurrence was 3.692 times for the latter. Preoperative serum HE4 level was independent prognostic factors for shorter overall survival and disease free survival in patients with EC. Preoperative routine measurement of serum HE4 levels in EC patients could provide high clinical value for EC patients’ prediction of prognosis.