title: The clinical significance of DJ-1 and HE4 in patients with endometrial cancer.
abstract: BACKGROUND
  The non-invasive diagnostic approach for early detection of endometrial cancer (EC) remains limited. To date, human epididymis protein 4 (HE4) has been intensively studied but its diagnostic is controversial in EC. DJ-1 is an oncoprotein secreted by cancer cells, recently identified as a potential diagnostic biomarker for breast cancer, melanoma, and pancreatic cancer. The aim of this study was to compare the diagnostic performances of DJ-1 and HE4 measured in EC patients and healthy controls (HC).
  
  
  METHODS
  Forty-five patients (63.9±12.0 years) with EC and 29 (63.2±13.3 years) HC were enrolled. Serum concentrations of DJ-1 and HE4 were measured using ELISA kits developed by R&D (Minneapolis, USA) and Fujirebio Diagnostic (Malvern, PA, USA), respectively. Differences between EC patients and HC were assessed by Mann-Whitney test and associations were tested by Spearman's correlation. The diagnostic performance was assessed using receiver operating characteristics (ROC) curves analysis.
  
  
  RESULTS
  Serum DJ-1 concentrations were found to be higher in EC patients than in HC (9533.6 vs 1988.5 pg/mL; P<.0001). The area under the ROC curve (ROC-AUC) was 0.95 (P<.0001). At the cut-off of 3654 pg/mL, the sensitivity and specificity were 0.89 and 0.90, respectively. HE4 serum levels were higher in EC patients than in HC (75.3 vs 56.2 pmol/L; P=.019), with an AUC of 0.66 (P=.020). The AUC obtained by the combination of the two markers resulted 0.96 (P<.0001).
  
  
  CONCLUSIONS
  These results suggest that increased serum DJ-1 levels are associated with EC and that this biomarker may be potentially useful for diagnosing EC.
authors.affiliation: Department of Neurological, Biomedical and Movement Sciences, Clinical Biochemistry Section, University of Verona, Verona, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Benati
authors.affiliation: Department of Neurological, Biomedical and Movement Sciences, Clinical Biochemistry Section, University of Verona, Verona, Italy.
authors.forename: Martina
authors.identifier: http://orcid.org/0000-0001-8999-0001
authors.initials: M
authors.lastname: Montagnana
authors.affiliation: Department of Neurological, Biomedical and Movement Sciences, Clinical Biochemistry Section, University of Verona, Verona, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Danese
authors.affiliation: Department of Neurological, Biomedical and Movement Sciences, Clinical Biochemistry Section, University of Verona, Verona, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Paviati
authors.affiliation: Department of Surgery, Obstetrics and Gynaecology Section, University of Verona, Verona, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Giudici
authors.affiliation: Department of Neurological, Biomedical and Movement Sciences, Clinical Biochemistry Section, University of Verona, Verona, Italy.
authors.forename: Orazio
authors.initials: O
authors.lastname: Ruzzenente
authors.affiliation: Department of Surgery, Obstetrics and Gynaecology Section, University of Verona, Verona, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Franchi
authors.affiliation: Department of Neurological, Biomedical and Movement Sciences, Clinical Biochemistry Section, University of Verona, Verona, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lippi
mesh_terms: D000368:Aged; D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000097:blood*; D016022:Case-Control Studies; D016889:Endometrial Neoplasms / Q000097:blood* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D000071617:Protein Deglycase DJ-1 / Q000097:blood*; D011506:Proteins / Q000032:analysis*; D000081102:WAP Four-Disulfide Core Domain Protein 2
chemical_list: D014408:Biomarkers, Tumor; D011506:Proteins; D000081102:WAP Four-Disulfide Core Domain Protein 2; C569698:WFDC2 protein, human; C105131:PARK7 protein, human; D000071617:Protein Deglycase DJ-1
keywords: DJ-1; HE4; PARK7; endometrial cancer