Pınar Kemik1, Bahadır Saatli2, Nuri Yıldırım3, Vahit Doğu Kemik4, Banu Deveci5, Mustafa Coşan Terek6, Semra Koçtürk7, Meral Koyuncuoğlu8, Uğur Saygılı9. 1. Fatma Hatun Hospital, Department of Obstetrics and Gynecology, Bolu, Turkey. Electronic address: drpinarkarabacak@yahoo.com.tr. 2. Dokuz Eylül University, Faculty of Medicine, Department of Obstetrics and Gynecology, Izmir, Turkey. Electronic address: bahadir.saatli@deu.edu.tr. 3. Ege University, Faculty of Medicine, Department of Obstetrics and Gynecology, Izmir, Turkey. Electronic address: nuri-yildirim@hotmail.com. 4. Cagsu Hospital, Department of Obstetrics and Gynecology, Bolu, Turkey. Electronic address: vahitdogukemik@gmail.com. 5. Buca Children and Women Hospital, Department of Biochemistry, Izmir, Turkey. Electronic address: dr_banu_deveci@yahoo.com. 6. Ege University, Faculty of Medicine, Department of Obstetrics and Gynecology, Izmir, Turkey. Electronic address: terekmc@yahoo.com. 7. Dokuz Eylül University, Faculty of Medicine, Department of Biochemistry, Izmir, Turkey. Electronic address: semra.kocturk@deu.edu.tr. 8. Dokuz Eylül University, Faculty of Medicine, Department of Pathology, Izmir, Turkey. Electronic address: meral.koyuncuoglu@deu.edu.tr. 9. Dokuz Eylül University, Faculty of Medicine, Department of Obstetrics and Gynecology, Izmir, Turkey. Electronic address: saygiliu@hotmail.com.
Abstract
OBJECTIVE: The objective of this study is to determine the efficiency of YKL-40, HE-4 and DKK-3 levels in early diagnosis of patients with endometrial cancer and in the pre-operative estimation of the prognostic parameters such as stage, grade and the extension of the disease. METHODS: In this prospective study, 50 patients diagnosed with endometrial cancer and 50 women as a control group, who applied to Dokuz Eylul University and Ege University Faculties of Medicine, Obstetrics and Gynecology Clinics between May 2011-May 2012 were included. CA125, HE-4, YKL-40 and DKK-3 serum levels were measured by ELISA and compared between two groups. The relation between serum levels and histopathological results, extension of disease and prognostic factors were analyzed. RESULTS: Preoperative serum CA125, HE-4 and YKL-40 levels were significantly higher in endometrial cancer group (p<0.001). Serum HE-4 levels were significantly higher in advanced stages (p=0.004). When we examined early stage patients, YKL-40 levels were significantly higher in non-endometrioid histology compared with endometrioid adenocarcinoma (p=0.022). We also examined the relation between the markers and prognostic factors. Different from other markers, HE-4 levels were significantly higher in endometrial cancer patients who had lymphovascular space involvement, lower uterine segment involvement, endocervical stromal involvement, and deep myometrial invasion. CONCLUSION: YKL-40 and HE-4 were significantly higher in patients with endometrial cancer. HE-4 seems to be superior to YKL-40 in discriminating early and advanced stages. Additionally, HE4 is significantly correlated with prognostic factors. HE-4 and YKL-40 may be successful in early determination of endometrial cancer and in detection of high risk subsets before surgery.
OBJECTIVE: The objective of this study is to determine the efficiency of YKL-40, HE-4 and DKK-3 levels in early diagnosis of patients with endometrial cancer and in the pre-operative estimation of the prognostic parameters such as stage, grade and the extension of the disease. METHODS: In this prospective study, 50 patients diagnosed with endometrial cancer and 50 women as a control group, who applied to Dokuz Eylul University and Ege University Faculties of Medicine, Obstetrics and Gynecology Clinics between May 2011-May 2012 were included. CA125, HE-4, YKL-40 and DKK-3 serum levels were measured by ELISA and compared between two groups. The relation between serum levels and histopathological results, extension of disease and prognostic factors were analyzed. RESULTS: Preoperative serum CA125, HE-4 and YKL-40 levels were significantly higher in endometrial cancer group (p<0.001). Serum HE-4 levels were significantly higher in advanced stages (p=0.004). When we examined early stage patients, YKL-40 levels were significantly higher in non-endometrioid histology compared with endometrioid adenocarcinoma (p=0.022). We also examined the relation between the markers and prognostic factors. Different from other markers, HE-4 levels were significantly higher in endometrial cancerpatients who had lymphovascular space involvement, lower uterine segment involvement, endocervical stromal involvement, and deep myometrial invasion. CONCLUSION:YKL-40 and HE-4 were significantly higher in patients with endometrial cancer. HE-4 seems to be superior to YKL-40 in discriminating early and advanced stages. Additionally, HE4 is significantly correlated with prognostic factors. HE-4 and YKL-40 may be successful in early determination of endometrial cancer and in detection of high risk subsets before surgery.
Authors: Lili Ge; Guangquan Liu; Kai Hu; Ke Huang; Mi Zhang; Juan Zhou; Fang Teng; Jian Cao; Chencheng Dai; Xuemei Jia Journal: Technol Cancer Res Treat Date: 2020 Jan-Dec