Article Text
Abstract
Introduction/Background Uterine Endometrial cancer is the most common malignancy of female reproductive system. There are various opinions about Pelvic and para-aortic lymphadenectomy during surgical staging in endometrial cancer. Several oncologists believe that total lymphadenectomy may lead to several surgical morbidities without any significant benefits for more surveillance. Especially in patients who had comorbidities. The purpose of this study is to investigate the correlation between serum level of tumor markers with stages, histological types, grade, myometrium invasion and lymph nodes involvement in patients.
Methodology A total of 131 participants with EC enrolled in this cross sectional research. preoperative serum levels of CA125 and HE4 were measured in patients one week before surgery.Then, stages, grade and lymph nodes involvement were recorded based on pathological findings. After analyzing via SPSS software, P value<0.05 was considered significant
Results 131 patients with endometrial cancer (70 patients with stage IA, 31 stage IB, 15 stage II, 15 stage III) were analyzed. The serum levels of CA125 and HE4 were significantly higher in higher stages( more than IA ),(p=0.016 and p=0.004 respectively). Both of tumor markers levels were significantly higher in patients with lymph node involvement, cervical invasion and myometrium invasion. In logistic regression we found significant correlation between HE4 (OR=1.005, P=0.035) and grade (OR=2.137, P=0.005).
Conclusion HE4 and CA125 are useful for predicting high risk patients. We found sensitivity 64% and specificity 60% at cut off of 70 pmol/l of HE4 for stage IA versus stage >IA. Although we have not found ideal cut off which is defined as higher than 80%,but such a 60% cut off also can be considerable for preoperative evaluation of endometrial cancer surgical staging.
Disclosures This study was done by Tehran university of medical sciences grant.