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Abstract
Introduction/Background*This study was undertaken to evaluate and compare CA125 and HE4 serum concentrations in the early postpartum period.
Methodology In a prospective designed, monocentric study (Department of Gynecology & Obstetrics, General and Teaching Hospital, Celje, Slovenia, EU), 68 women who were in the 1-3rd day of postpartum period were included in the study.
HE4 and CA125 levels were obtained and analysed with regard to each day of postpartum period (1st, 2nd and 3rd day after delivery) as well as regarding the method of delivery (vaginal delivery; n=46, elective (ElCS); n=15 and emergency caesarean section (EmCS); n=8).
CA125 and HE4 levels were measured in consideration of their reference intervals less than 35 IU/ml and less than 140 pmol/l, respectively (Elecsys CA 125 II® assay and Elecsys HE4® assay, Roche Diagnostics Ltd., Rotkreuz, Switzerland).
Data were analysed by ANOVA (MedCalc Software, Mariakerke, Belgium).
Result(s)*The CA-125 levels were frequently above the conventional cut-off limit of 35 IU/mL; differences in mean concentrations between study groups were not found to be statistically significant (Group I, n=44, 1st day after delivery, mean = 39,4 IU/ml; Group II, n = 19, 2nd day after delivery, mean = 32,8 IU/ml; Group III, n =5, 3rd day after delivery, mean = 38,8 IU/ml, p= 0,708).
Regarding the method of delivery, women in the vaginal delivery group had seemingly higher levels of CA125 than the women in both caesarean section groups, but still not statistically significant (44,0 IU/ml vs 29,7 IU/ml (ElCS) and 21,5 IU/ml (EmCS), respectively; p=0,057.
HE4 levels were within reference range and significant difference was also not observed between 1st, 2nd and 3rd day postpartaly (Group I, n=44, 1st day after delivery, mean = 60,3 pmol/l; Group II, n = 19, 2nd day after delivery, mean = 54,3 pmol/l; Group III, n =5, 3rd day after delivery, mean = 49,2 pmol/l, p= 0,096).
Regarding the method of delivery, women in the vaginal delivery group had significantly lower levels of HE4 than the women in both caesarean section groups (54,5 pmol/l vs 65,7 pmol/l (ElCS) and 61,1 pmol/l (EmCS), respectively; p=0,015.
Conclusion*According to our preliminary results, HE4 is more reliable marker of malignancy during the early postpartum period than CA125.