ArticleWorld journal of clinical oncology2020
Preoperative markers for the prediction of high-risk features in endometrial cancer.
Article in World journal of clinical oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 17 citations in OpenAlex.
- Article
- The Relationship between Systemic Expression Levels of Immune Cells and Tumor Markers and High-Risk HPV Infection in Patients with Cervical Cancer, Cervical Intraepithelial Neoplasia, and Chronic Cervicitis, and its Clinical Significance.International journal of women's health · 2025Article
- Serum Anti-Mullerian Hormone Levels Might Indicate Premenopausal Endometrial Lesions.Diagnostics (Basel, Switzerland) · 2023Article
- The Diagnostic Role of FGF 21 in Endometrial Cancer and Other Pathologies of the Uterine Corpus.Diagnostics (Basel, Switzerland) · 2023Article
- Multiparametric magnetic resonance imaging-based radiomics nomogram for predicting tumor grade in endometrial cancer.Frontiers in oncology · 2023Article
- Serum CA125 and HE4 as Biomarkers for the Detection of Endometrial Cancer and Associated High-Risk Features.Diagnostics (Basel, Switzerland) · 2022Article
- CA125 as a predictor of endometrial cancer lymphovascular space invasion and lymph node metastasis for risk stratification in the preoperative setting.Scientific reports · 2022Article
- Assessing Metabolic Risk Factors for LVSI in Endometrial Cancer: A Cross-Sectional Study.Therapeutics and clinical risk management · 2022Article
- Current and Emerging Prognostic Biomarkers in Endometrial Cancer.Frontiers in oncology · 2022Review
- HE4 as a Biomarker for Endometrial Cancer.Cancers · 2021Review
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2 authors at 1 institution in 1 country.
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Abstract
backgroundPreoperative evaluations aiming to assess high-risk features in clinical stage 1 endometrial cancer patients are crucial to refer these patients to gynecologic oncologists. Cancer antigen 125 (CA125) and human epididymis protein 4 (HE4) have been reported in endometrial cancer patients with poor prognostic factors.
aimTo evaluate the association between preoperative levels of CA125 and HE4 and high-risk features and establish optimal cut-off values in clinical stage 1 endometrial cancer.
methodsA retrospective study was conducted in clinical stage 1 endometrial cancer patients who underwent primary surgery between January 2013 and December 2018. A total of 128 patients had preoperative serum CA125 and HE4 measurements. High-risk features included grade 3 tumors, large tumor sizes (more than 2 cm), deep myometrial invasion (more than 50%), lymphovascular space invasion (LVSI), cervical involvement, extrauterine involvement and node metastasis. Receiver operating characteristic (ROC) curves were generated to analyze the optimal cut-off values.
resultsThe mean age of the patients was 57.4 years, and 69.5% of them were postmenopausal. Most patients presented with stage I disease (67.2%) and had the endometrioid subtype (97.7%). The median CA125 and HE4 levels in all patients were 22.1 U/mL and 104.7 pmol/L, respectively. CA125 and HE4 levels were significantly elevated in those with large tumor sizes, deep myometrial invasion, LVSI, extrauterine metastasis, and advanced stage, but node metastasis was associated with elevated CA125 only. According to the ROC curve, both serum markers had statistical significance for the prediction of high-risk features only in postmenopausal patients, with an optimal cut-off value of 20 U/mL for CA125 [area under the concentration-time curve (AUC) = 0.72,
conclusionPreoperative CA125 levels greater than 20 U/mL or HE4 levels greater than 113 pmol/L are associated with an increased risk of having high-risk features and present as prognostic factors in clinical stage 1 postmenopausal endometrial cancer patients. This information is helpful for general gynecologists to refer high-risk patients to gynecologic oncologists to perform complete surgical staging.
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