Utility of Tumor Marker HE4 to Predict Depth of Myometrial Invasion in Endometrioid Adenocarcinoma of the Uterus

作者：Moore Richard G^*; Miller Craig Michael; Brown Amy K; Robison Katina; Steinhoff Margaret; Lambert Messerlian Geralyn

来源：International Journal of Gynecological Cancer, 2011, 21(7): 1185-1190.

DOI：10.1097/IGC.0b013e3182229ad8

• Endometrial cancer
• Lymphadenectomy
• HE4
• Surgical staging
• Myometrial invasion

Objective: The purpose of this pilot study was to determine whether the biomarker human epididymis protein 4 (HE4) correlates with depth of myometrial invasion, histologic grade, lymph vascular space invasion, positive cytologic washings, and nodal metastases in patients with endometrioid adenocarcinoma of the uterus.
Methods: This was a prospective, observational study in women with biopsy-proven endometrioid adenocarcinoma. Concentrations of HE4 were assessed before surgery, and all surgical specimens were reviewed by dedicated gynecologic pathologists.
Results: Included were a total of 96 women with endometrioid adenocarcinomas of the uterus, most (77%) with stage I disease. Levels of serum HE4 greater than 70 pM displayed a sensitivity of 94% and a negative predictive value of 97% in identifying stage IA (<50% myometrial invasion) versus stage IB (>= 50% myometrial invasion) tumors and a sensitivity of 82% and negative predictive value of 82% versus all more advanced tumors.
Conclusions: Human epididymis protein 4 may be a useful marker preoperatively in the clinical decision process for determining the need for lymph node dissection in women with endometrioid endometrial cancer.

• 出版日期2011-10