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Role of HE4 and CA125 Predicting EOC Surgery

February, 02, 2024 | Gynecologic Cancer, Ovarian Cancer

KEY TAKEAWAYS

  • The study investigated the correlation between pre-operative HE4 and CA125 levels in non-mucinous EOC patients.
  • Researchers noticed an association between lower levels of HE4 and CA125 in non-mucinous EOC among OS compared to SS, suggesting predictive markers for optimal surgery.

Kanokwan Promchit and her team aimed to explore the connection between pre-operative HE4 and CA125 levels in non-mucinous epithelial ovarian cancer (EOC) cases and their impact on primary surgery outcomes, specifically focusing on predicting optimal surgery.

Researchers performed an inclusive analysis in a retrospective study involving non-mucinous EOC patients who underwent primary surgery. Demographic and clinical characteristics, histopathology, and pre-operative tumor markers (HE4 and CA125) were collected. Surgical outcomes were categorized as optimal (OS) or suboptimal surgery (SS).

About 170 patients participated in the study, with 130 undergoing OS and 40 experiencing SS. EOC patients’ average age and body mass index (BMI) were 54.2 years and 23.1 Kg/m2, respectively, showing comparable demographic characteristics between both groups. Among the participants, (103/170) two-thirds had early-stage disease, while (63/170) one-third exhibited clear cell histopathology.

The median HE4 levels were 118.60 pmol/L in OS and 603.45 pmol/L in SS, demonstrating notable differences. Similarly, OS and SS patients had average CA125 levels of 146.95 and 814.70 U/L, respectively. The optimal cut-off points for predicting OS were less than 170.95 pmol/L for HE4 and 316.4 U/mL for CA125. The corresponding area under the curve (AUC) values were 0.78 for HE4 and 0.75 for CA125.

In terms of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), the HE4 cut-off point exhibited percentages of 60.8/60.8, 87.5/82.5, 94.1/91.9, and 40.7/39.3, respectively.

The study concluded that HE4 and CA125 levels in non-mucinous EOC were significantly lower among patients with OS than SS. 

No funding was provided for the study.

Source: https://pubmed.ncbi.nlm.nih.gov/38285795/

Promchit K, Oranratanaphan S. et al (2024). “Human Epididymis Protein 4 (HE4) and Cancer Antigen 125 (CA125) for Prediction of Optimal Primary Surgery in Non-Mucinous Epithelial Ovarian Cancer.” Asian Pac J Cancer Prev. 2024 Jan 1;25(1):281-286. doi: 10.31557/APJCP.2024.25.1.281. PMID: 38285795.

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