The role of Novel Biomarker HE4 in Endometrial Cancer

Abstract

Summary E ndometrial cancer is one of the most important leading causesof cancer deaths among women. Endometrial cancer is the seventh most commonly diagnosed gynecologic malignancy in the United States. In recent years, several articles have been published about HE4 as a new tumor marker used in diagnosis of endometrial cancer. In our study we evaluate the ability of serum HE4 concentration to differentiate between benign endometrial lesions and endometrial cancer. The present study was carried out at Ain shams University Maternity Hospital, Gynecologic Hospitalized patients during the period from August 2013 till June 2014. The study included a total of 60 women who are suffering of postmenopausal bleeding and planned for hysterectomy. Assessment of the results of study revealed that the mean age of study cases is 60.6±6.5 years, median range of parity is 4, and regarding BMI the mean is 29.3±4.7.

Regarding staging of endometrial cancer:  Stage I 18 cases (60.6%)  Stage II 4 cases (13.3%)  Stage III 6 cases (20%)  Stage IV 2 case 6.7%) Our results revealed that no significant differences between women with benign endometrial lesions and those with endometrial cancer regarding the age, parity, weight, BMI, age at menarche and age at menopause. Regarding differences in serum levels of tumor marker HE4, we found a highly significant increase in serum HE4 in women with endometrial cancer [IQR 184.15 (146-287)] compared with serum HE4 in women with benign endometrial lesion [IQR 37.5 (18.28-59.88)]. Also our results demonstrated that a serum HE4 concentration 76pmol/L was associated with endometrial cancer at sensitivity of 90.0 %, specificity of 98.3%, positive predictive value (PPV) of 100%, negative predictive value (NPV) of 83.3%. Regarding the false positive cases the results show no false positive case with serum HE4; and regarding false negative cases the results show 6 false negative case with HE4.