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http://dx.doi.org/10.7314/APJCP.2016.17.5.2507

Comparison of Diagnostic Accuracies of Serum HE-4 Levels and 3D Power Doppler Angiography Parameters between Benign Endometrial Pathologies and Endometrial Cancer  

Erenel, Hakan (Department of Obstetrics and Gynecology, Sisli Hamidiye Etfal Training and Research Hospital)
Bese, Tugan (Department of Obstetrics and Gynecology, Sisli Hamidiye Etfal Training and Research Hospital)
Sal, Veysel (Department of Obstetrics and Gynecology, Sisli Hamidiye Etfal Training and Research Hospital)
Demirkiran, Fuat (Department of Obstetrics and Gynecology, Sisli Hamidiye Etfal Training and Research Hospital)
Arvas, Macit (Department of Obstetrics and Gynecology, Sisli Hamidiye Etfal Training and Research Hospital)
Publication Information
Asian Pacific Journal of Cancer Prevention / v.17, no.5, 2016 , pp. 2507-2511 More about this Journal
Abstract
Purpose: To study the diagnostic accuracies of serum human epididymis protein 4 (HE-4) levels, virtual organ computer-aided analysis (VOCAL) parameters and endometrial volume in endometrial cancer cases. Materials and Methods: One hundred and seven patients (37 with endometrial cancer and 70 with benign endometrial pathology) were included in this study. VOCAL parameters and serum HE-4 levels were compared between the groups. Results: Area under the curve (AUC) values were 0.702, 0.658, 0.706 for vascularization index (VI), the flow index (FI) and the vascularization flow index (VFI), respectively. A cut off value of 0.568 for VI demonstrated 70% sensitivity, 72% specificity, 56% positive predictive value (PPV) and a81% negative predictive value (NPV). A cut off value of 25.8 for showed a senitivith of 70% and a specificity of 58% with aPPV of 46% and NPV of 78%, and with a cut off value of 0.12 for VFI 70%, 69%, 54% and 81%, respectively. The area under the curve for HE-4 was 0.814. A cut off value of 458 pmol/L was predictive of malignancy with 86% sensitivity and 63% specificity. Conclusions: VOCAL parameters and serum HE-4 levels were statistically significantly higher in the endometrial cancer patients. Serum HE-4 levels provided a greater sensitivity compared to power doppler angiography for predicting malignancy or benign endometrial pathology.
Keywords
Endometrial cancer; colour doppler; HE-4 protein; three-dimensional; ultrasonography;
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1 Alcazar JL, Galvan R (2009). Three-dimensional power Doppler ultrasound scanning for the prediction of endometrial cancer in women with postmenopausal bleeding and thickened endometrium. Am J Obstet Gynecol, 200, 44.
2 Amant F, Moerman P, Neven P, et al (2005). Endometrial cancer. Lancet, 366, 491-505.   DOI
3 Angioli R, Miranda A, Aloisi A, et al (2014). A critical review on HE-4 performance in endometrial cancer: where are we now? Tumour Biol, 35, 881-7.   DOI
4 Atguden Z, Yildiz A, Aksut H, et al (2016). The value of preoperative CA-125 levels in prediction of myometrial invasion in patients with early-stage endometrioid-type endometrial cancer. Asian Pac J Cancer Prev, 17, 497-501.   DOI
5 Bie Y, Zhang Z (2014). Diagnostic value of serum HE-4 in endometrial cancer: a meta-analysis. World J Surg Oncol, 12, 169.   DOI
6 Brennan DJ, Hackethal A, Mann KP, et al (2015). Serum HE-4 detects recurrent endometrial cancer in patients undergoing routine clinical surveillance. BMC Cancer, 15, 33.   DOI
7 Merce LT, Alcazar JL, Lopez C, et al (2007). Clinical usefulness of 3-dimensional sonography and power Doppler angiography for diagnosis of endometrial carcinoma. J Ultrasound Med, 26, 1279-87.   DOI
8 Creutzberg CL, van Putten WL, Koper PC, et al (2000). Surgery and postoperative radiotherapy versus surgery alone for patients with stage-1 endometrial carcinoma: multicentre randomised trial. PORTEC Study Group. Postoperative radiation therapy in endometrial carcinoma. Lancet, 355, 1404-11.   DOI
9 Lin JY, Qin JB, Li XY, Dong P, Yin BD (2012). Diagnostic value of human epididymis protein 4 compared with mesothelin for ovarian cancer: a systematic review and meta-analysis. Asian Pac J Cancer Prev, 13, 5427-32.   DOI
10 Makled AK, Elmekkawi SF, El-Refaie TA, El-Sherbiny MA (2013). Three-dimensional power Doppler and endometrial volume as predictors of malignancy in patients with postmenopausal bleeding. J Obstet Gynaecol Res, 39, 1045-51.   DOI
11 Odeh M, Vainerovsky I, Grinin V, et al (2007). Three-dimensional endometrial volume and 3-dimensional power Doppler analysis in predicting endometrial carcinoma and hyperplasia. Gynecol Oncol, 106, 348-53.   DOI
12 Minar L, Klabenesova I, Jandakova E, Zlamal F, Bienertova-Vasku J (2015). Prognostic value of human epididymis protein 4 in endometrial cancer and its utility for surgical staging. J Obstet Gynaecol Res, 41, 1644-52.   DOI
13 Moore RG, Brown AK, Miller MC, et al (2008). Utility of a novel serum tumor biomarker HE-4 in patients with endometrioid adenocarcinoma of the uterus. Gynecol Oncol, 110, 196-201.   DOI
14 Moore RG, Miller MC, Steinhoff MM, et al (2012). Serum HE-4 levels are less frequently elevated than CA125 in women withbenign gynecologic disorders. Am J Obstet Gynecol, 206, 351.
15 Smith-Bindman R, Weiss E, Feldstein V (2004). How thick is too thick? When endometrial thickness should prompt biopsy in postmenopausal women without vaginal bleeding. Ultrasound Obstet Gynecol, 24, 558-65.   DOI
16 Opolskiene G, Sladkevicius P, Jokubkiene L, Valentin L (2010). Three-dimensional ultrasound imaging for discrimination between benign and malignant endometrium in women with postmenopausal bleeding and sonographic endometrial thickness of at least 4.5 mm. Ultrasound Obstet Gynecol, 35, 94-102.   DOI
17 Ortiz-Munoz B, Aznar-Oroval, E, Garcia Garcia A, et al (2014). HE-4, Ca125 and ROMA algorithm for differential diagnosis between benign gynaecological diseases and ovarian cancer. Tumour Biol, 35, 7249-58.   DOI
18 Papanikolaou A, Kalogiannidis I, Goutzioulis M, et al (2006). Pelvic lymphadenectomy as alternative to postoperative radiotherapy in high risk early stage endometrial cancer. Arch Gynecol Obstet, 274, 91-6.   DOI
19 Raine-Fenning N, Campbell B, Collier J, Brincat M, Johnson I (2002). The reproducibility of endometrial volume acquisition and measurement with the VOCAL-imaging program. Ultrasound Obstet Gynecol, 19, 69-75.   DOI
20 Rossi A, Forzano L, Romanello I, Fachechi G, Marchesoni D (2012). Assessment of endometrial volume and vascularization using transvaginal 3D power Doppler angiography in women with postmenopausal bleeding. Int J Gynaecol Obstet, 119, 14-7.   DOI
21 Sood AK, Buller RE, Burger RA, et al (1997). Value of preoperative CA-125 level in the management of uterine cancer and prediction of clinical outcome. Obstet Gynecol, 90, 441-7.   DOI