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Uterine Cancer
Utility of Tumor Marker HE4 to Predict Depth of Myometrial Invasion in Endometrioid Adenocarcinoma of the Uterus
  1. Richard G. Moore, MD*,†,
  2. Craig Michael Miller, BSc*,
  3. Amy K. Brown, MD‡,
  4. Katina Robison, MD†,
  5. Margaret Steinhoff, MD§ and
  6. Geralyn Lambert-Messerlian, PhD*,†,§
  1. *Center for Biomarkers and Emerging Technologies and
  2. †Program in Women's Oncology, Department of Obstetrics and Gynecology, Women and Infants Hospital, Brown University, Providence, RI;
  3. ‡Department of Obstetrics and Gynecology, Hartford Hospital, Hartford, CT; and
  4. §Department of Pathology, Women and Infants Hospital, Brown University, Providence, RI.
  1. Address correspondence and reprint requests to Richard G. Moore, MD, Center for Biomarkers and Emerging Technologies and Program in Women's Oncology, Department of Obstetrics and Gynecology, Women and Infants Hospital, 101 Dudley St, Providence, RI 02905. E-mail: rmoore{at}wihri.org.

Abstract

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.

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

https://doi.org/10.1097/IGC.0b013e3182229ad8

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    Footnotes

    • R.M. received research support from Abbott Diagnostics and Fujirebio Diagnostics, Inc; G.L.-M. has received unrestricted sponsored research support from Beckman Coulter Inc.; and C.M. is a consultant for Fujirebio Diagnostics, Inc.