https://doi.org/10.4081/ejtm.2022.10671
Predicting value of HE4 and CA125 markers for optimal cytoreductive surgery in ovarian cancer patients
Submitted: 13 June 2022
Accepted: 26 June 2022
Published: 1 August 2022
Accepted: 26 June 2022
Abstract Views: 951
PDF: 485
HTML: 8
HTML: 8
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
We conducted a cross-sectional study to evaluate the role of serum levels of CA125 and HE4 in predicting optimal cytoreductive surgery. Eligible women who had been diagnosed with ovarian cancer based on both clinical and imaging criteria were enrolled in this study. Serum levels of CA 125 and HE4 were checked before surgery and all patients underwent complete surgical staging. After completion of the pathological evaluation, data were entered in SPSS version 23. One hundred and ten individuals were enrolled in our study. We divided cases between two groups: stage I to III b and stage IIIc to IV. Serum level of HE4 >170 pmol/L can predict optimal cytoreductive surgery before operation. (sensitivity:80% and specificity 70%) and serum level of CA 125 > 320 UI/mL can predict optimal cytoreductive surgery before operation. (sensitivity:80% and specificity 70%). Our data demonstrated a negative predictive value of about 80% for both HE4 and CA125. Based on these cut-off, unnecessary surgery can be avoided in many cases, however, it is unwise to ignore clinical performance and radiological findings. Nevertheless, we can say the evaluation of tumor markers is feasible and helpful in predicting optimal surgery.
Liu Y, Chen S, Zheng C, Ding M, Zhang L, Wang L, Xie M, Zhou J. The prognostic value of the preoperative c-reactive protein/albumin ratio in ovarian cancer. BMC Cancer. 2017 Apr 21;17(1):285.
DOI: https://doi.org/10.1186/s12885-017-3220-x
Heintz A, Odicino F, Maisonneuve P, Quinn M, Benedet J, Creasman W. Carcinoma of the fallopian tube. Int J Gynecol Obstetrics.2006:95:S145-S60.
DOI: https://doi.org/10.1016/S0020-7292(06)60032-5
Niloff JM, Knapp RC, Schaetzl E, Reynolds C, Bast RC Jr. CA125 antigen levels in obstetric and gynecologic patients. Obstet Gynecol. 1984 Nov;64(5):703-7.
Scaletta G, Plotti F, Luvero D, Capriglione S, Montera R, Miranda A, Lopez S, Terranova C, De Cicco Nardone C, Angioli R. The role of novel biomarker HE4 in the diagnosis, prognosis and follow-up of ovarian cancer: a systematic review. Expert Rev Anticancer Ther. 2017 Sep;17(9):827-839. Epub 2017 Aug 3.
DOI: https://doi.org/10.1080/14737140.2017.1360138
Romagnolo C, Leon AE, Fabricio ASC, Taborelli M, Polesel J, Del Pup L, Steffan A, Cervo S, Ravaggi A, Zanotti L, Bandiera E, Odicino FE, Scattolo N, Squarcina E, Papadakis C, Maggino T, Gion M. HE4, CA125 and risk of ovarian malignancy algorithm (ROMA) as diagnostic tools for ovarian cancer in patients with a pelvic mass: An Italian multicenter study. Gynecol Oncol. 2016 May;141(2):303-311. Epub 2016 Jan 19.
DOI: https://doi.org/10.1016/j.ygyno.2016.01.016
Ramalingam P. Morphologic, Immunophenotypic, and Molecular Features of Epithelial Ovarian Cancer. Oncology (Williston Park). 2016 Feb;30(2):166-76.
Wei SU, Li H, Zhang B. The diagnostic value of serum HE4 and CA-125 and ROMA index in ovarian cancer. Biomed Rep. 2016 Jul;5(1):41-44. Epub 2016 May 19.
DOI: https://doi.org/10.3892/br.2016.682
Chen X, Zhou H, Chen R, He J, Wang Y, Huang L, Sun L, Duan C, Luo X, Yan H. Development of a multimarker assay for differential diagnosis of benign and malignant pelvic masses. Clin Chim Acta. 2015 Feb 2;440:57-63. Epub 2014 Nov 15.
DOI: https://doi.org/10.1016/j.cca.2014.11.013
Jacobs I, Oram D, Fairbanks J, Turner J, Frost C, Grudzinskas JG. A risk of malignancy index incorporating CA 125, ultrasound and menopausal status for the accurate preoperative diagnosis of ovarian cancer. Br J Obstet Gynaecol. 1990 Oct;97(10):922-9.
DOI: https://doi.org/10.1111/j.1471-0528.1990.tb02448.x
Montagnana M, Lippi G, Ruzzenente O, Bresciani V, Danese E, Scevarolli S, Salvagno GL, Giudici S, Franchi M, Guidi GC. The utility of serum human epididymis protein 4 (HE4) in patients with a pelvic mass. J Clin Lab Anal. 2009;23(5):331-5.
DOI: https://doi.org/10.1002/jcla.20340
Molina R, Escudero JM, Augé JM, Filella X, Foj L, Torné A, Lejarcegui J, Pahisa J. HE4 a novel tumour marker for ovarian cancer: comparison with CA 125 and ROMA algorithm in patients with gynaecological diseases. Tumour Biol. 2011 Dec;32(6):1087-95. Epub 2011 Aug 24.
DOI: https://doi.org/10.1007/s13277-011-0204-3
Paek J, Lee SH, Yim GW, Lee M, Kim YJ, Nam EJ, Kim SW, Kim YT. Prognostic significance of human epididymis protein 4 in epithelial ovarian cancer. Eur J Obstet Gynecol Reprod Biol. 2011 Oct;158(2):338-42. Epub 2011 Jun 17.
DOI: https://doi.org/10.1016/j.ejogrb.2011.05.021
Vergote I. Role of surgery in ovarian cancer: an update. Acta Chir Belg. 2004 Jun;104(3):246-56.
DOI: https://doi.org/10.1080/00015458.2004.11679550
Bristow RE, Duska LR, Lambrou NC, Fishman EK, O'Neill MJ, Trimble EL, Montz FJ. A model for predicting surgical outcome in patients with advanced ovarian carcinoma using computed tomography. Cancer. 2000 Oct 1;89(7):1532-40.
DOI: https://doi.org/10.1002/1097-0142(20001001)89:7<1532::AID-CNCR17>3.0.CO;2-A
Axtell AE, Lee MH, Bristow RE, Dowdy SC, Cliby WA, Raman S, Weaver JP, Gabbay M, Ngo M, Lentz S, Cass I, Li AJ, Karlan BY, Holschneider CH. Multi-institutional reciprocal validation study of computed tomography predictors of suboptimal primary cytoreduction in patients with advanced ovarian cancer. J Clin Oncol. 2007 Feb 1;25(4):384-9.
DOI: https://doi.org/10.1200/JCO.2006.07.7800
Angioli R, Palaia I, Zullo MA, Muzii L, Manci N, Calcagno M, Panici PB. Diagnostic open laparoscopy in the management of advanced ovarian cancer. Gynecol Oncol. 2006 Mar;100(3):455-61. Epub 2005 Dec 1.
DOI: https://doi.org/10.1016/j.ygyno.2005.09.060
Fagotti A, Fanfani F, Ludovisi M, Lo Voi R, Bifulco G, Testa AC, Scambia G. Role of laparoscopy to assess the chance of optimal cytoreductive surgery in advanced ovarian cancer: a pilot study. Gynecol Oncol. 2005 Mar;96(3):729-35.
DOI: https://doi.org/10.1016/j.ygyno.2004.11.031
Fagotti A, Ferrandina G, Fanfani F, Garganese G, Vizzielli G, Carone V, Salerno MG, Scambia G. Prospective validation of a laparoscopic predictive model for optimal cytoreduction in advanced ovarian carcinoma. Am J Obstet Gynecol. 2008 Dec;199(6):642.e1-6. Epub 2008 Sep 17.
DOI: https://doi.org/10.1016/j.ajog.2008.06.052
Memarzadeh S, Lee SB, Berek JS, Farias-Eisner R. CA125 levels are a weak predictor of optimal cytoreductive surgery in patients with advanced epithelial ovarian cancer. Int J Gynecol Cancer. 2003 Mar-Apr;13(2):120-4.
DOI: https://doi.org/10.1136/ijgc-00009577-200303000-00003
Obeidat B, Latimer J, Crawford R. Can optimal primary cytoreduction be predicted in advanced stage epithelial ovarian cancer? Role of preoperative serum CA-125 level. Gynecol Obstet Invest. 2004;57(3):153-6. Epub 2004 Jan 15.
DOI: https://doi.org/10.1159/000076236
Angioli R, Plotti F, Capriglione S, Aloisi A, Montera R, Luvero D, Miranda A, Cafà EV, Damiani P, Benedetti-Panici P. Can the preoperative HE4 level predict optimal cytoreduction in patients with advanced ovarian carcinoma? Gynecol Oncol. 2013 Mar;128(3):579-83. Epub 2012 Dec 7.
DOI: https://doi.org/10.1016/j.ygyno.2012.11.040
Feng LY, Liao SB, Li L. Preoperative serum levels of HE4 and CA125 predict primary optimal cytoreduction in advanced epithelial ovarian cancer: a preliminary model study. J Ovarian Res. 2020 Feb 12;13(1):17.
DOI: https://doi.org/10.1186/s13048-020-0614-1
Tian Y, Wang C, Cheng L, Zhang A, Liu W, Guo L, Ye H, Huang Y, Chen J, Wen X, Xing Y, Zheng G, Sun Z, Li H, Zhang P, Liu W, Chen Y, Zhang Z, Xu Y, Huo Y, Ou Q. Determination of reference intervals of serum levels of human epididymis protein 4 (HE4) in Chinese women. J Ovarian Res. 2015 Nov 9;8:72.
DOI: https://doi.org/10.1186/s13048-015-0201-z
Chudecka-Głaz AM, Cymbaluk-Płoska AA, Menkiszak JL, Sompolska-Rzechuła AM, Tołoczko-Grabarek AI, Rzepka-Górska IA. Serum HE4, CA125, YKL-40, bcl-2, cathepsin-L and prediction optimal debulking surgery, response to chemotherapy in ovarian cancer. J Ovarian Res. 2014 Jun 10;7:62.
DOI: https://doi.org/10.1186/1757-2215-7-62
Furrer D, Grégoire J, Turcotte S, Plante M, Bachvarov D, Trudel D, Têtu B, Douville P, Bairati I. Performance of preoperative plasma tumor markers HE4 and CA125 in predicting ovarian cancer mortality in women with epithelial ovarian cancer. PLoS One. 2019 Jun 20;14(6):e0218621.
DOI: https://doi.org/10.1371/journal.pone.0218621
How to Cite
Saffarieh, E., Nassiri, S., & Mirmohammadkhani, M. (2022). Predicting value of HE4 and CA125 markers for optimal cytoreductive surgery in ovarian cancer patients. European Journal of Translational Myology, 32(3). https://doi.org/10.4081/ejtm.2022.10671
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.