title: HE4 is an independent prognostic marker in endometrial cancer patients.
abstract: OBJECTIVE
  To evaluate the prognostic value of pretherapeutic serum HE4 in endometrial cancer in comparison to CA125.
  
  
  METHODS
  HE4 and CA125 serum levels were analyzed by means of chemiluminescent microparticle immunoassays in 183 patients with endometrial cancer treated at the Department of Obstetrics and Gynecology, Innsbruck Medical University, between 1999 and 2009. The Kaplan-Meier method and Cox's proportional hazards analysis were performed to determine the prognostic significance of HE4, CA125 and the combination of both markers.
  
  
  RESULTS
  In univariate analysis both markers, HE4 and CA125, were of prognostic value for overall survival (p<0.001 and p=0.028) and disease-free survival (p=0.015 and p=0.045). In multivariate analysis HE4 was seen to have independent prognostic value in overall survival (HR 2.407, p=0.017) in contrast to CA125. The combination of both markers showed a higher hazard ratio (HR 4.04, p=0.023) for overall survival in comparison to HE4 alone. In the subgroup endometrioid histological type (n=132) only HE4 was of prognostic value for overall survival in univariate (p=0.001) and multivariate analysis (p=0.023).
  
  
  CONCLUSIONS
  Pretherapeutic serum HE4 levels alone and in combination with CA125 are an independent prognostic marker in endometrial cancer patients.
authors.affiliation: Department of Obstetrics and Gynecology, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Irene
authors.initials: I
authors.lastname: Mutz-Dehbalaie
authors.forename: Daniel
authors.initials: D
authors.lastname: Egle
authors.forename: Siegfried
authors.initials: S
authors.lastname: Fessler
authors.forename: Michael
authors.initials: M
authors.lastname: Hubalek
authors.forename: Heidi
authors.initials: H
authors.lastname: Fiegl
authors.forename: Christian
authors.initials: C
authors.lastname: Marth
authors.forename: Andreas
authors.initials: A
authors.lastname: Widschwendter
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D018394:CA-125 Antigen / Q000097:blood; D016889:Endometrial Neoplasms / Q000097:blood* / Q000473:pathology; D005260:Female; D006801:Humans; D007118:Immunoassay; D008163:Luminescent Measurements; D008875:Middle Aged; D011379:Prognosis; D011506:Proteins / Q000378:metabolism*; D016019:Survival Analysis; D000081102:WAP Four-Disulfide Core Domain Protein 2
chemical_list: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D011506:Proteins; D000081102:WAP Four-Disulfide Core Domain Protein 2; C569698:WFDC2 protein, human