scholarly journals Comparison of MRI, CA-125 and HE-4 in determining the depth of myometrial invasion in cases with endometrial cancer

2021 ◽  
Vol 6 (1) ◽  
pp. 22-29
Author(s):  
Samican Özmen ◽  
Sefa Kurt ◽  
Orkun Ilgen ◽  
Funda Barlik Obuz ◽  
Ali Riza Sisman ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Clinical Stage ◽  
Preoperative Evaluation ◽  
Screening Method ◽  
Myometrial Invasion ◽  
Cost Effective ◽  
Serum Levels ◽  
Ca 125 ◽  
Success Rates ◽  
Preoperative Serum

Objective. Endometrial cancer is one of the most common malignancies in the world. There is no effective screening method used for predicting the clinical stage of the disease in the preoperative period and to plan the surgical procedure. The aim of this study is to compare the serum levels of CA-125 and HE-4 with MRI, to evaluate their ability to predict the depth of myometrial invasion in patients diagnosed with endometrial cancer, and to compare the specificity between these two tests. Materials and Methods. This prospective study was conducted at Dokuz Eylul University Faculty of Medicine, Department of Obstetrics and Gynecology, between February 2019 and February 2020. A total of 47 cases were included in the study. The cases were evaluated with MRI preoperatively to determine the extent of the disease. Preoperative serum CA-125 and HE4 levels were measured by ELISA method and compared, and the superiority of the tests to each other in determining the depth of myometrial invasion was evaluated. Results. In patients with endometrioid cancer, preoperative CA-125 and HE-4 levels were found to be higher if the myometrial invasion is >50% and lymphovascular space invasion is positive, and the difference was statistically significant. A cut-off of 7,05 U/ml for CA-125 could detect the deeper myometrial invasion with a sensitivity of 83% and a specificity of 52%, respectively. A cut-off of 94,25 pmol/L for HE-4 could detect deeper myometrial invasion with a sensitivity of 75% and a specificity of 56%, respectively. The sensitivity of MRI in determining the depth of myometrial invasion was 87,1%, and the specificity was 86,7%. Conclusions. MRI, HE-4 and CA-125 were found to be valuable tests in predicting the extent of the disease and planning the surgical treatment. All three methods successfully predicted the myometrial invasion depth of the disease. The success rates of the tests in predicting the depth of myometrial invasion were MRI, HE-4 and CA-125, respectively. HE-4 and CA-125 could not reach the sensitivity and specificity of MRI in determining the depth of myometrial invasion at any cut-off value. However, it was proved in this study that they can play important roles as simpler and more cost-effective tests in determining the extent of the disease, able to contribute to surgical planning during preoperative evaluation.

Serum concentration of VEGF, sFLT-1, and CD105 in patients with endometrial carcinoma.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15564-e15564
Author(s):  
Johanna Maenpaa ◽  
Sami Kristian Saarelainen ◽  
Nina Peltonen ◽  
Terho Lehtimaki ◽  
Maarit Vuento
Keyword(s):  
Serum Concentration ◽  
Endometrial Carcinoma ◽  
Preoperative Evaluation ◽  
Multivariable Analysis ◽  
Myometrial Invasion ◽  
Serum Levels ◽  
Disease Stage ◽  
Enzyme Linked Immunosorbent Assay ◽  
Preoperative Serum ◽  
Study Results

e15564 Background: Preoperative evaluation of the risk for metastases in endometrial carcinoma is challenging. The aim of this study was to compare preoperative serum levels of angiogenetic markers VEGF, sFLT-1, and CD105 (endoglin) in predicting a metastasized disease. Methods: Preoperative sera from 100 consecutive patients diagnosed for endometrial carcinoma were collected. The serum concentrations of VEGF, sFLT-1, and CD105 were assessed by enzyme-linked immunosorbent assay (ELISA). The results were correlated to the presence of metastases, presence of deep (≥50%) myometrial invasion and histologic grade of the tumor. Cases with other than endometrioid histology were excluded from the study. Results: Eleven patients had a metastasized disease (≥Stage IIIA, FIGO 2009 classification). The serum concentration of VEGF was higher in the group with metastases (median [range] 394 pg/mL [31-1524 pg/mL] vs. 801 pg/mL [631-1183 pg/mL], p=0.001). The concentrations of sFLT-1 and CD105 did not show statistical difference between the two groups. In the multivariable analysis, the concentration of VEGF was the sole independent factor for the presence of metastases (OR 1.003, 95% CI 1.000-1.005, p=0.019). Conclusions: Preoperative serum VEGF concentration correlates with the presence of metastases in endometrioid endometrial carcinoma.

scholarly journals Relationship between CA-125 Levels and Extrauterine Spread in Endometrial Cancer Endometrioid Type at Dr. Soetomo General Hospital Surabaya

2021 ◽  
Vol 15 (2) ◽  
pp. 60
Author(s):  
Brahmana Askandar ◽  
Andika Adi Saputra
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Significant Relationship ◽  
Early Stage ◽  
Clinical Stage ◽  
Myometrial Invasion ◽  
Ca 125 ◽  
Cancer Antigen 125 ◽  
Cancer Management

Background: Endometrial cancer is the sixth most common malignancy incidence in women worldwide. The surgical staging in endometrial cancer management such as bilateral salpingooophorectomy and lymphadenectomy is not a routine procedure for all endometrial cancer patients. Therefore, a biomarker to estimate the presence of endometrial cancer metastases to adnexa and lymph nodes is needed. This study aims to find out the level of cancer antigen 125 (CA-125) in endometrial cancer endometrioid type and the relationship between the level of CA-125 and the incidence of adnexal metastases, lymph node metastases, clinical stage, and myometrial invasion.Methods: This observational analytic study used a direct observational design. The in-vitro quantitative examination was performed to measure CA-125 levels using CA-125 Advia Centaur CA-125 Kit. Fischer exact test used to analyzed CA-125 levels with the subject characteristics. All the statistical analyses were performed using SPSS v. 21.0.Results: Of the 30 research subjects with the characteristics of the most age groups of 51–60 years (60%), with the most multiparous parity (73.3%), grade III (43.3%), myometrial invasion > 50% by 66.7%, early-stage (63.3%), the incidence of adnexal metastases (30%), and the incidence of lymph node (LN) metastases (10%), a significant relationship between CA-125 levels and lymph node (LN) metastases was found with a p = 0.041 and the phi association of 0.016 and between CA-125 levels and adnexal metastases with a p = 0.035 and the phi association of 0.026. There was also a significant relationship between CA-125 levels and the clinical stage (advanced stage) with p = 0.004 and the phi association of 0.002. There is no significant relationship with a p = 0.702 and a phi association value of -0.098.Conclusions: CA-125 can be used as a tumor marker to predict the presence of extrauterine metastases (adnexa & lymph nodes).

scholarly journals The Utility of CA125 and HE4 in Patients Suffering From Endometrial Cancer

2019 ◽  
Vol 8 (1) ◽  
pp. 95-100
Author(s):  
Narges Zamani ◽  
Mitra Modares Gilani ◽  
Majid Mirmohammadkhani ◽  
Sharzad Sheikhhasani ◽  
Azamsadat Mousavi ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Preoperative Evaluation ◽  
Myometrial Invasion ◽  
Lymph Node Involvement ◽  
Surgical Staging ◽  
P Value ◽  
Preoperative Serum ◽  
Serum Ca125 ◽  
Node Involvement

Objectives: Uterine endometrial cancer (EC) is the most common female reproductive system malignancy. There are various comments on pelvic and para-aortic lymphadenectomy during the surgical staging of EC. Several oncologists believe that total lymphadenectomy, in some cases, may lead to operative morbidity without any considerable advantage over more surveillance, especially in patients with comorbidities. The purpose of the current study was to examine the correlation between serum tumor marker levels and stage, grade, histological type, myometrial invasion, and lymph node involvement in EC. Materials and Methods: A total of 131 patients with EC participated in the present cross-sectional study. Preoperative serum CA125 and HE4 levels were evaluated 1 week before surgery. Then, the stage, grade, and lymph node involvement were recorded according to the pathological findings. After Data analysis through SPSS software, P value<0.05 was considered to be significant. Results: One hundred thirty-one patients with EC (70, 31, 15, and 15 patients in sequence with stages IA, IB, II, and III) were analyzed. The serum CA125 and HE4 levels were significantly higher in more advanced stages (over IA), (P=0.016 and P=0.004, respectively). Levels of both tumor markers were significantly higher in patients with lymph node involvement, and cervical and myometrial invasions. In logistic regression analysis, a significant correlation was found between HE4 level (odds ratio [OR]=1.005, P=0.035) and grade of disease (OR=2.137, P=0.005). Conclusions: HE4 and CA125 are useful for predicting high-risk patients. Sensitivity of 64% and specificity of 60% were indicated at cut-off value of 70 pmol/L for HE4 in stage IA in comparison with stages over IA. Although the ideal cut-off which is defined as higher than 80% was not obtained, such a cut-off (60%) can also be considered for preoperative evaluation of surgical staging of EC.

Clinical and diagnostic aspects of deep infiltrative endometriosis (diagnosis, treatment, recurrence)

GYNECOLOGY ◽  
2021 ◽  
Vol 23 (4) ◽  
pp. 307-313
Author(s):  
Shakhnoza K. Muftaidinova ◽  
Leonid Z. Faizullin ◽  
Vladimir D. Chuprynin ◽  
Nikolai S. Ruseikin ◽  
Tatiana I. Smolnova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Hormonal Therapy ◽  
Serum Levels ◽  
Ca 125 ◽  
Prior History ◽  
Deep Endometriosis ◽  
Preoperative Serum ◽  
Peritoneal Endometriosis ◽  
History Of ◽  
Deep Infiltrative Endometriosis

Aim. To analyze the recurrence of endometriosis after surgical treatment of patients with deep endometriosis. Materials and methods. The case histories of 90 patients aged 19 to 45 years were retrospectively analyzed. The study group consisted of 70 endometriosis patients: 20 with peritoneal endometriosis and 50 with deep infiltrative endometriosis (DIЕ). The comparison group included 20 women without endometriosis. There was an in-depth study of anamnestic data in the cohort of patients under study. The results of preoperative laboratory tests, including serum levels of the CA-125 and CA 19-9 oncomarkers, were processed. Results. Analysis of the obtained data showed that about half of the DIE patients (54%) in the main group had a history of surgical interventions for endometriosis. The number of operations was significantly higher in patients compared to the peritoneal endometriosis group (68% vs 20%, respectively; р=0.0012). Two subgroups were formed from the group of women with DIE: patients who had no history of previous surgical treatment for endometriosis and those hospitalized for repeated surgical treatment of endometriosis (patients with recurrent endometriosis). Patients with recurrent endometriosis had a significantly higher incidence of heavy menstruation, pregnancy terminations (abortions), and a high proportion of gastrointestinal diseases. Analysis of the hormonal therapy received in patients with DIE showed that every second patient with relapses (18/53%) after surgical treatment and every third patient without a prior history of surgery (5/31%) received hormonal therapy. Examination of the preoperative serum levels of CA-125 and CA 19-9 serum markers in patients with DIE showed an increase in their serum levels and a correlation with the frequency of endometriosis recurrence and the size of DIE foci. Conclusion. Despite the conservative and surgical treatment of DIE patients, the recurrence rate is still high. At present, there is no satisfactory therapy for all endometriosis patients. Therefore, the development of therapy for the conservative treatment of the disease remains an urgent task.

scholarly journals Clinical Significance of Serum Interleukin-31 and Interleukin-33 Levels in Patients of Endometrial Cancer: A Case Control Study

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Xi Zeng ◽  
Zhu Zhang ◽  
Qian-Qian Gao ◽  
Yan-Yun Wang ◽  
Xiu-Zhang Yu ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Tumor Markers ◽  
Sensitivity And Specificity ◽  
Serum Levels ◽  
Ca 125 ◽  
Depth Of Invasion ◽  
Healthy Controls ◽  
Clinical Markers ◽  
Interleukin 33 ◽  
Tumor Stages

Aims. Previous evidence has proved that interleukin-31 (IL-31) and interleukin-33 (IL-33) can be potential markers in some cancers’ formulation. We aimed to determine the potential role of IL-31 and IL-33 in prognosis of endometrial cancer patients.Methods. Serum samples were collected from 160 patients with endometrial cancer and 160 healthy controls. The ELISA kits (Raybio® Systems) specific for human IL-31 and human IL-33 were used. Serum levels of tumor markers (CEA, CA-125, and CA19-9) were measured by chemiluminescence immunoassay. A two-sidePvalue < 0.05 was indicated to be significant.Results. Serum levels of IL-31 and IL-33 in patients were significantly elevated compared to those of healthy controls. The interleukin levels were also related to clinical characteristics, including tumor stages, depth of invasion, and existence of node metastases and distant metastases. The sensitivity and specificity of IL-31 and IL-33 were higher than the counterparts of tumor markers, both separately and in combination of IL-31, IL-33, and the clinical markers.Conclusions. This report is the first one mentioning the possible association between serum IL-31 and IL-33 and endometrial cancer. With their sensitivity and specificity, the interleukins may be useful biomarkers for endometrial cancer’s prognosis.

Predicting Model of Lymph Node Metastasis Using Preoperative Tumor Grade, Transvaginal Ultrasound, and Serum CA-125 Level in Patients With Endometrial Cancer

2016 ◽  
Vol 26 (9) ◽  
pp. 1630-1635 ◽  
Author(s):  
Jisun Lee ◽  
Tae-Wook Kong ◽  
Jiheum Paek ◽  
Suk-Joon Chang ◽  
Hee-Sug Ryu
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Myometrial Invasion ◽  
Tumor Grade ◽  
Ca 125 ◽  
Transvaginal Sonography ◽  
Endometrioid Adenocarcinoma ◽  
Predicting Model ◽  
Node Metastasis

ObjectiveThe purpose of this study was to evaluate the predicting model for lymph node metastasis using preoperative tumor grade, transvaginal sonography (TVS), and serum cancer antigen 125 (CA-125) level in patients with endometrial cancer.Materials and MethodsBetween January 2000 and February 2013, we identified 172 consecutive patients with surgically staged endometrial cancer. Transvaginal sonography was performed by an expert gynecologic radiologist in all patients. All patients had complete staging surgery including total hysterectomy with bilateral pelvic and para-aortic lymphadenectomy and were staged according to the 2009 International Federation of Gynecology and Obstetrics classification. Various clinicopathologic data were obtained from medical records and were retrospectively analyzed.ResultsOf 172 patients, 138 patients presented with stage I (118 IA and 20 IB), 12 had stage II, 18 had stage III (2 IIIA, 1 IIIB, 8 IIIC1, and 7 IIIC2), and 2 had stage IV diseases. Most patients had endometrioid adenocarcinoma (88.4%), and others (12.6%) had nonendometrioid histology. Eighteen patients (10.5%) were found to have lymph node metastasis. Deep myometrial invasion on preoperative TVS (≥50%), high serum CA-125 level (≥ 35 IU/mL), preoperative grade 2 or 3 tumors were significant preoperative factors predicting lymph node metastasis. There was no significant association between preoperative histology and lymph node metastasis. We calculated the simple model predicting lymph node metastasis based on preoperative tumor grade, TVS findings, and CA-125 level using logistic regression analysis. The sensitivity and specificity of this model were 94% and 57%, respectively (area under the curve, 0.84; 95% confidence interval [CI], 0.74–0.93; P < 0.01).ConclusionsPreoperative tumor grade, myometrial invasion on preoperative TVS, and CA-125 can accurately predict lymph node metastasis in patients with endometrial cancer. The current study suggests the possibility that TVS could be positively used for preoperative evaluation strategy in the low-resource countries instead of expensive imaging modalities such as magnetic resonance imaging or positron emission tomography–computed tomography.

Preoperative Serum CA 125 Level as a Predictor for Metastasis and Survival in Endometrioid Endometrial Cancer

2011 ◽  
Vol 33 (8) ◽  
pp. 844-850 ◽  
Author(s):  
B. Pinar Cilesiz Goksedef ◽  
Husnu Gorgen ◽  
Safak Yilmaz Baran ◽  
Murat Api ◽  
Ahmet Cetin
Keyword(s):  
Endometrial Cancer ◽  
Ca 125 ◽  
Preoperative Serum ◽  
Endometrioid Endometrial Cancer

scholarly journals Evaluation of preoperative, intraoperative and postoperative myometrial invasion in endometrial cancers: comparıson of MRI, frozen and final pathology results

2021 ◽  
Vol 3 (1) ◽  
pp. 1-8
Author(s):  
Kemine Uzel
Keyword(s):  
Endometrial Cancer ◽  
Sensitivity And Specificity ◽  
Myometrial Invasion ◽  
High Sensitivity ◽  
Tumor Grade ◽  
Ca 125 ◽  
Estimation Model ◽  
Gynecological Malignancy ◽  
Training And Research ◽  
Magnetic Resonance Imaging Mri

Aim: Endometrial cancer is a gynecological malignancy that accounts for approximately 7% of new cancer cases and 4% of cancer-related deaths in women. The most important factor determining the prognosis of this ailment isthe depth of myometrial invasion, which has been reported to be associated with the tumor grade, lymph node metastasis, and patient survival. The aim of this study was to investigate the effectiveness of magnetic resonance imaging (MRI) and frozen results in determining the depth of myometrial invasion needed to guide the intraoperative decision-making process in endometrial cancer patients by comparing them with paraffin results, to evaluate the accuracy rate and to establish a reliable estimation model by using other data in the study.Methods: In this study, the files of patients who underwent surgery for endometrial cancer between January 01, 2012 and January 31, 2019 in Kocaeli Derince Training and Research Hospital, Department of Obstetrics and Gynecology, were evaluated retrospectively.Results: The results of the paraffin examination were found to be in good agreement with the frozen results, while the MRI showed a moderate agreement (Kappa coefficient 0.741 and 0.414, respectively). A logistic regression model based on the MRI and frozen results included MRI (less or more 50% invasion), frozen (less or more 50% invasion), age, gravida, parity, and CA 125 (U/ml). The Nagelkerke R square value for this model was 84,0%, and the sensitivity and specificity of the model for predicting paraffin examination results were 90,5% and 97.3%, respectively.Conclusion: Compared to MRI, frozen results are more reliable in determining myometrial invasion when the paraffin result is accepted as the gold standard. Myometrial invasion can be estimated with high sensitivity and specificity using a model including MRI, frozen, CA 125, age, parity.

Sign in / Sign up

Export Citation Format

Share Document