title: Utility of tumor marker HE4 to predict depth of myometrial invasion in endometrioid adenocarcinoma of the uterus.
abstract: OBJECTIVE
  The purpose of this pilot study was to determine whether the biomarker human epididymis protein 4 (HE4) correlates with depth of myometrial invasion, histologic grade, lymph vascular space invasion, positive cytologic washings, and nodal metastases in patients with endometrioid adenocarcinoma of the uterus.
  
  
  METHODS
  This was a prospective, observational study in women with biopsy-proven endometrioid adenocarcinoma. Concentrations of HE4 were assessed before surgery, and all surgical specimens were reviewed by dedicated gynecologic pathologists.
  
  
  RESULTS
  Included were a total of 96 women with endometrioid adenocarcinomas of the uterus, most (77%) with stage I disease. Levels of serum HE4 greater than 70 pM displayed a sensitivity of 94% and a negative predictive value of 97% in identifying stage IA (<50% myometrial invasion) versus stage IB (≥ 50% myometrial invasion) tumors and a sensitivity of 82% and negative predictive value of 82% versus all more advanced tumors.
  
  
  CONCLUSIONS
  Human epididymis protein 4 may be a useful marker preoperatively in the clinical decision process for determining the need for lymph node dissection in women with endometrioid endometrial cancer.
authors: Department of Obstetrics and Gynecology, Women and Infants Hospital, Brown University, Providence, RI, USA. rmoore@wihri.org
authors: Richard G
authors: RG
authors: Moore
authors: Craig Michael
authors: CM
authors: Miller
authors: Amy K
authors: AK
authors: Brown
authors: Katina
authors: K
authors: Robison
authors: Margaret
authors: M
authors: Steinhoff
authors: Geralyn
authors: G
authors: Lambert-Messerlian
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D018269:Carcinoma, Endometrioid / Q000097:blood / Q000473:pathology*; D030501:Epididymal Secretory Proteins / Q000378:metabolism*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009215:Myometrium / Q000473:pathology*; D060787:Neoplasm Grading; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D014594:Uterine Neoplasms / Q000097:blood / Q000473:pathology*; D023083:beta-Defensins
chemical_list: D014408:Biomarkers, Tumor; C426184:DEFB126 protein, human; D030501:Epididymal Secretory Proteins; D023083:beta-Defensins