| Objective:To investigate the comparative analysis of preoperative CA125,HE4 and CEA in the prognosis of endometrial serous carcinoma.Methods:The clinical data and pathological results of 72 patients with endometrial serous carcinoma admitted to Jiangxi provincial maternal and child health center from January 1,2018 to December 31,2020 are retrospectively analyzed.Included patient information: tumor markers(CA125,HE4,CEA),postoperative pathological stage(52patients in stage I-II;20 patients with stage III-IV),postoperative pathological differentiation,muscular invasion,lymph node metastasis,survival outcome,diseasefree progression,overall survival,5-year survival rate.The different comparisons between the three tumor markers in postoperative pathological stage,postoperative pathological differentiation,muscular invasion,lymph node metastasis,disease-free progression and overall survival by SPSS 26.0 software.Results:The Chi-square test shows that there are differences in the distribution of USC patients in age,fertility,pathological stage,pathological grade and lymph node metastasis,but there is no difference in the distribution of muscular invasion.The double independent sample test shows that the level of HE4 before surgery is related to the postoperative pathological stages,the degree of muscular invasion,the metastasis of lymph nodes and degree of postoperative pathological differentiation,the difference is statistically significant(P<0.05).The level of preoperative CA125 is related to the postoperative pathological stages and the degree of muscular invasion,the difference is statistically significant(P<0.05),it is independent of lymph node metastasis and postoperative pathological differentiation.There is no significant difference(P>0.05),and the level of preoperative CEA is not significantly related to postoperative pathological stages,degree of muscular invasion,lymph node metastasis and postoperative pathological differentiation(P>0.05).The survival curve plotted by Kaplan-Meier,the average progression-free survival of HE4<140 pmol/ml is 56.58±1.91;the average overall survival of HE4<140 pmol/ml is 57.92±1.15,the average PFS of preoperative HE4≥140 pmol/ml is 20.74±2.84,the average OS of postoperative HE4≥140 pmol/ml is 38.38±1.83.The Log rank test showed that the HE4 PFS chi-square was 49.96,P<0.05;the HE4 OS chi-square was 43.29,P<0.05,and the difference in PFS and OS distribution of level before surgery is statistically significant(P<0.05).The average PFS of CA125<35 U/ml is 42.96±2.95;the average OS of CA125<35 U/ml is 50.23±1.69;the average PFS of CA125≥35 U/ml is28.06±5.42;the average OS of CA125≥35 U/ml is 40.64±3.43;the Log rank test showed that CA125 PFS chi-square is 6.25,P=0.012;CA125 OS chi-square is 5.97,P=0.015;and the difference in distribution of PFS and OS at CA125 level is statistically significant(P>0.05).The average PFS of CEA<5.00 U/ml is 39.94±3.39;the average OS of CEA<5.00 U/ml is 48.05±2.03;the average PFS of CEA≥5.00U/ml is 39.15±4.45;the average OS of CEA≥5.00 U/ml is 47.95±2.60;Log rank test shows that CEA PFS chi-square is 0.018,P=0.893;CEA OS chi-square is 0.029,P=0.866;and the difference in distribution of PFS and OS at CEA level is not statistically significant(P>0.05).Conclusion:Preoperative HE4 level has certain research value on postoperative pathological stage,muscular invasion,lymph node metastasis,and postoperative pathological differentiation.The preoperative CA125 level has certain research significance on the postoperative stage and the degree of muscular invasion.Preoperative HE4 and CA125 elevation is more meaningful for the evaluation of USC than preoperative CEA.Preoperative CEA elevation has no significant effect on disease-free progression and overall survival.The more pronounced the preoperative HE4 and CA125 elevation,the shorter the disease-free progression and overall survival.Preoperative HE4 and CA125 are better than CEA to help analyze the prognosis of USC patient.Selecting reasonable tumor markers is more helpful for physicians to judge the severity of the disease,choice of treatment options and evaluation of prognosis. |
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