HE4 is an independent prognostic marker in endometrial cancer patients

ObjectiveTo evaluate the prognostic value of pretherapeutic serum HE4 in endometrial cancer in comparison to CA125.MethodsHE4 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.ResultsIn 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).ConclusionsPretherapeutic serum HE4 levels alone and in combination with CA125 are an independent prognostic marker in endometrial cancer patients.

► Both markers, HE4 and CA125, are of prognostic value for overall and disease-free survival.
► HE4 was seen to have independent prognostic value in overall survival in contrast to CA125.
► The combination of both markers showed a higher hazard ratio for overall survival in comparison to HE4 alone.
► In the subgroup of endometrioid histological type only HE4 was an independent prognostic marker for overall survival.