Introduction/Background Lack of a definitive biomarker for screening and diagnosis of endometrial cancer precludes early diagnosis and treatment and it can only be confirmed on histopathology in symptomatic women.
The aim of the present study was to examine the role of human epididymis protein 4 (HE4) and fibrinogen in endometrial cancer. The objectives were to estimate and compare the biomarker levels in endometrial cancer and benign endometrial pathology and correlate them with various clinicopathological parameters of endometrial malignancy.
Methodology A total of 60 patients (30 cases and 30 controls) with endometrial cancer and benign endometrial pathology respectively were recruited in this case control study. HE4 and fibrinogen levels were estimated in both groups. The diagnostic value was assessed by a receiver operating curve, sensitivity, specificity, positive predictive value, negative predictive value and accuracy.
Results The mean (SD) HE4 levels were significantly higher for cases compared to controls (371.14pmol/L (258.82) and 207.85pmol/L (179.26); (p=0.017). Similarly, the mean (SD) fibrinogen value for cases was 421.20mg/dL (156) and 251mg/dL (104.4) for controls (p=0.00).A combination of HE4 and fibrinogen fared better than either biomarker alone in diagnosing endometrial cancer (area under the receiver operating curve: HE4 and fibrinogen = 0.86, fibrinogen=0.81 and HE4=0.68). At a cut-off level of 239 pmol/L for HE4 and 342.5mg/dL for fibrinogen, the sensitivity was 60% and 73.33% respectively and specificity was 76.67% and 83.33%. No statistically significant correlation was found between the values of these biomarkers and the pathological parameters.
Conclusion Both HE4 and fibrinogen were significantly raised in endometrial cancer cases than controls. Combination of serum HE4 and plasma fibrinogen had highest accuracy while plasma fibrinogen fared better as a standalone marker to differentiate between benign and malignant histology.
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