Comparison of Diagnostic Accuracies of Serum HE-4 Levels and 3D Power Doppler Angiography Parameters between Benign Endometrial Pathologies and Endometrial Cancer.
OBJECTIVE
To study the diagnostic accuracies of serum human epididymis protein 4 (HE-4) levels, virtual organ computer-aided analysis (VOCAL) parameters and endometrial volume in endometrial cancer cases.


METHODS
One hundred and seven patients (37 with endometrial cancer and 70 with benign endometrial pathology) were included in this study. VOCAL parameters and serum HE-4 levels were compared between the groups.


RESULTS
Area under the curve (AUC) values were 0.702, 0.658, 0.706 for vascularization index (VI), the flow index (FI) and the vascularization flow index (VFI), respectively. A cut off value of 0.568 for VI demonstrated 70% sensitivity, 72% specificity, 56% positive predictive value (PPV) and a81% negative predictive value (NPV). A cut off value of 25.8 for showed a senitivith of 70% and a specificity of 58% with aPPV of 46% and NPV of 78%, and with a cut off value of 0.12 for VFI 70%, 69%, 54% and 81%, respectively. The area under the curve for HE-4 was 0.814. A cut off value of 458 pmol/L was predictive of malignancy with 86% sensitivity and 63% specificity.


CONCLUSIONS
VOCAL parameters and serum HE-4 levels were statistically significantly higher in the endometrial cancer patients. Serum HE-4 levels provided a greater sensitivity compared to power doppler angiography for predicting malignancy or benign endometrial pathology.
Department of Obstetrics and Gynecology, Sisli Hamidiye Etfal Training and Research Hospital, Sisli, Istanbul E-mail : hakanerenel@yahoo.com.
Hakan
H
Erenel
Tugan
T
Bese
Veysel
V
Sal
Fuat
F
Demirkiran
Macit
M
Arvas
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods*; D014408:Biomarkers, Tumor / Q000097:blood*; D016022:Case-Control Studies; D016889:Endometrial Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D004717:Endometrium / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D011506:Proteins / Q000032:analysis*; D012372:ROC Curve; D018608:Ultrasonography, Doppler / Q000379:methods*; D000081102:WAP Four-Disulfide Core Domain Protein 2
D014408:Biomarkers, Tumor; D011506:Proteins; D000081102:WAP Four-Disulfide Core Domain Protein 2; C569698:WFDC2 protein, human