Charles University in Prague, Czech Republic
Problem statement: Our aims were to evaluate the benefits of the determination of human epididymis protein 4 (HE4) in the endometrial cancer diagnostics. We compared HE4 with cancer antigen 125 (CA125).
Methods: The total number of females was 66. The patient group consisted of 32 females with endometrial cancer and the control group of 34 healthy females. All diagnoses were verified histologically with equal representation of tumors in FIGO stage I - IV. Age distribution of Ca endomerial group and healthy controls group were very similar. The average age was 58.5 and 65 years. HE4 were measured using ELISA kit (Fujirebio Diagnostics, Sweden). CA125 were measured using DxI instrument (Beckman Coulter, USA). The SAS 9.2 Software was used for all statistical analysis. Wilcoxon test was used to the comparison of cancer and healthy group.
Results: When HE4 was evaluated at 96.88% specificity: cut-off: 90.0 pmol/L, sensitivity: 41.18%, positive predictive value: 93.33%, negative predictive value: 60.78% and an area under the curve: 0.8056. Comparison of distribution of Wilcoxon score between cancer and healthy group was statistically significant p<0.0001. CA125 was evaluated at 96.88% specificity: cut-off: 42.0 IU/L, sensitivity: 20.59%, positive predictive value: 87.50%, negative predictive value: 53.45% and an area under the curve: 0.5700. Comparison of distribution of Wilcoxon score between cancer and healthy group was statistically not significant p=0.4442.
Conclusions: Measurement of HE4 is more sensitive than CA125 determination. Determination of HE4 is an useful tool for improving of endometrial cancer detection and next strategy of treatment.