The clinical value of serum HE4, CA125 and CA199 in identifying the myometrial invasion depth and pathological stage of uterine corpus endometrial carcinoma

Abstract:

Objective: To detect the serum molecular markers for diagnosing depth of tumor invasion and FIGO stage in endometrial carcinoma（EC）. Methods: The expression levels of human epididymal protein E4（HE4），carcinoembryonic antigen（CEA），carbohydrate antigen 125（CA125），carbohydrate antigen 199（CA199），carbohydrate antigen 724（CA724） and alpha fetoprotein（AFP） in 212 EC patients’ serum samples were measured and the correlation between them and pathological parameters was analyzed. The positive expression rates of HE4，CEA，CA125，CA199，CA724 and AFP in the serum were further analyzed，and the sensitivity，specificity and the receiver operating characteristic（ROC） curve were also calculated in each index alone and combined to compare diagnostic efficiency. Results: The expression level and positive rates of HE4，CA125 and CA199 in serum were statistically different between EC invasion depth < 1/2 myometrial and endometrial cancer invasion depth ≥ 1/2 myometrium，and were also different between FIGO stage Ⅰ/Ⅱ and Ⅲ/Ⅳ. The sensitivity，specificity and accuracy of HE4+CA125+CA199 in the diagnosis of invasion depth ≥ 1/2 and FIGO stage Ⅲ/Ⅳ were relatively higher. The area under the ROC curve of HE4+CA125+CA199 in diagnosing depth ≥ 1/2 and stage Ⅲ/Ⅳ were larger than that of HE4 single diagnosis，CA125 single diagnosis，CA199 single diagnosis，HE4+CA125 combined diagnosis，HE4+CA199 combined diagnosis and CA125+CA199 combined diagnosis. Conclusion: The combined detection of HE4，CA125 and CA199 in serum supports diagnosing the invasion depth more than a half and FIGO stage Ⅲ/Ⅳ and predicting high-risk factors of EC.