Background: Endometrial carcinoma is the most common gynaecological malignant tumour in developed countries. At present, no routinely used serum biomarker is available for the prediction of lymph node metastasis (LNM). This study thus evaluates the potential of tumour markers CA125 and HE4 as LNM predictors in endometrial carcinoma patients.Objectives: The aim of this study was to evaluate the potential use of CA125 and HE4 and to assess the viability of a model developed using the parameters of serum tumour marker levels for LNM risk stratification.Methods: A retrospective, single-institution study of 220 patients with biopsy-proven endometrial carcinoma was conducted from May 2020 to December 2023. Preoperative serum levels of HE4 and CA125 were determined. All patients underwent surgical lymph node staging. The study evaluated the sensitivity and specificity of tumour markers and of the developed LNM risk prediction model.Results: No LNM was observed in 167 of the 220 patients (75.9%), micrometastatic lymph node involvement was observed in 13 patients (5.9%), and macrometastatic involvement was observed in 24 patients (10.9%). Median CA125 and HE4 levels were significantly higher in patients with LNM than in those without. With a CA125 cut-off value of 35 IU/mL, a sensitivity of 70% and a specificity of 92% were obtained, while an HE4 cut-off value of 103 pmol/L yielded a sensitivity of 78% and a specificity of 80%. A prediction model combining CA125, HE4, and the extent of uterine invasion, as detected by ultrasound, yielded a sensitivity of 84% and a specificity of 98% in predicting LNM.Conclusions: CA125 and HE4, along with the prediction model, facilitate endometrial carcinoma patient subdivision into low- and high-risk LNM groups. As this method is technically simple, non-invasive, and inexpensive, it could be of undeniable benefit in the risk stratification of patients with multiple comorbidities, which limit the duration and extent of surgery.
背景：子宫内膜癌是发达国家最常见的妇科恶性肿瘤。目前尚无常规应用的血清生物标志物可用于预测淋巴结转移。本研究旨在评估肿瘤标志物CA125和HE4作为子宫内膜癌患者淋巴结转移预测指标的潜力。 目的：本研究旨在评估CA125和HE4的潜在应用价值，并探讨基于血清肿瘤标志物水平参数构建的淋巴结转移风险分层模型的可行性。 方法：本研究为回顾性单中心研究，纳入2020年5月至2023年12月经活检确诊的220例子宫内膜癌患者。检测所有患者术前血清HE4和CA125水平，所有患者均接受手术淋巴结分期。研究评估了肿瘤标志物及所构建的淋巴结转移风险预测模型的敏感性和特异性。 结果：220例患者中167例（75.9%）未发现淋巴结转移，13例（5.9%）存在微转移淋巴结受累，24例（10.9%）存在宏转移受累。淋巴结转移患者的中位CA125和HE4水平显著高于无转移患者。当CA125截断值为35 IU/mL时，敏感性为70%，特异性为92%；而HE4截断值为103 pmol/L时，敏感性为78%，特异性为80%。结合CA125、HE4及超声检测的子宫侵犯程度构建的预测模型，在预测淋巴结转移时显示出84%的敏感性和98%的特异性。 结论：CA125和HE4及预测模型有助于将子宫内膜癌患者划分为低危和高危淋巴结转移组。该方法技术简单、无创且成本低廉，对于存在多种合并症（限制手术时长和范围）患者的风险分层具有不可否认的临床价值。
肿瘤(癌症)患者之家