title: Preoperative CA125 and fibrinogen in patients with endometrial cancer: a risk model for predicting lymphovascular space invasion.
abstract: OBJECTIVE
  The aim of this study was to build a model to predict the risk of lymphovascular space invasion (LVSI) in women with endometrial cancer (EC).
  
  
  METHODS
  From December 2010 to June 2013, 211 patients with EC undergoing surgery at Shanghai First Maternity and Infant Hospital were enrolled in this retrospective study. Those patients were divided into a positive LVSI group and a negative LVSI group. The clinical and pathological characteristics were compared between the two groups; logistic regression was used to explore risk factors associated with LVSI occurrence. The threshold values of significant factors were calculated to build a risk model and predict LVSI.
  
  
  RESULTS
  There were 190 patients who were negative for LVSI and 21 patients were positive for LVSI out of 211 patients with EC. It was found that tumor grade, depth of myometrial invasion, number of pelvic lymph nodes, and International Federation of Gynecology and Obstetrics (FIGO) stage (p<0.05) were associated with LVSI occurrence. However, cervical involvement and age (p>0.05) were not associated with LVSI. Receiver operating characteristic (ROC) curves revealed that the threshold values of the following factors were correlated with positive LVSI: 28.1 U/mL of CA19-9, 21.2 U/mL of CA125, 2.58 mg/dL of fibrinogen (Fn), 1.84 U/mL of carcinoembryonic antigen (CEA) and (6.35×10⁹)/L of white blood cell (WBC). Logistic regression analysis indicated that CA125 ≥21.2 (p=0.032) and Fn ≥2.58 mg/dL (p=0.014) were significantly associated with LVSI.
  
  
  CONCLUSIONS
  Positive LVSI could be predicted by CA125 ≥21.2 U/mL and Fn ≥2.58 mg/dL in women with EC. It could help gynecologists better adapt surgical staging and adjuvant therapies.
authors.affiliation: Department of Gynecology, Shanghai First Maternity and Infant Hospital, Tongji University, Shanghai, China.
authors.forename: Xingchen
authors.identifier: http://orcid.org/0000-0003-4245-4249
authors.initials: X
authors.lastname: Zhou
authors.affiliation: Department of Gynecology, Shanghai First Maternity and Infant Hospital, Tongji University, Shanghai, China.
authors.forename: Husheng
authors.identifier: http://orcid.org/0000-0002-4203-2188
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Gynecology, Shanghai First Maternity and Infant Hospital, Tongji University, Shanghai, China. xipengwang@hotmail.com.
authors.forename: Xipeng
authors.identifier: http://orcid.org/0000-0001-9029-0803
authors.initials: X
authors.lastname: Wang
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000556:secondary / Q000601:surgery; D018394:CA-125 Antigen / Q000032:analysis*; D016022:Case-Control Studies; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D005340:Fibrinogen / Q000032:analysis*; D006801:Humans; D016015:Logistic Models; D008207:Lymphatic Metastasis / Q000175:diagnosis / Q000473:pathology*; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies; D012306:Risk; D012680:Sensitivity and Specificity
chemical_list: D018394:CA-125 Antigen; D005340:Fibrinogen
keywords: CA-125 Antigen; Endometrial Neoplasms; Fibrinogen; Lymphovascular Space Invasion