Endometrial Cancer Clinical Trial
Official title:
Evaluation of Serum Human Epididymis Secretory Protein 4 (HE4) in Benign Endometrial Disease and Endometrial Cancer
Endometrial cancer represents the most common gynecologic cancer, and it is expected to
become an even greater public health concern as the prevalence of obesity, one of the most
common risk factors for endometrial cancer, increases worldwide.
Almost 20% of patients with endometrial cancer are in the premenopausal state and 10% are
asymptomatic. In such a case, it is much harder to make an early diagnosis and usually they
are probably diagnosed at advanced stages.
An earlier diagnosis represents an imperative goal to improve survival and prognosis of
patients of endometrial cancer. Actually, there are no certified screening tools for
endometrial cancer. Pelvic ultrasound as screening for endometrial cancer-reaches 80.5% of
sensitivity, when endometrial echo is > 5 mm, but it dramatically decreases to 20% in
asymptomatic women; moreover, specificity is low (61%).
Human epididymis protein 4, a putative protease inhibition containing two Whey Acid Protein
domains, is significantly increased in the endometrioid subtype of endometrial carcinoma.
Tissue microarray and polymerase chain reaction studies confirmed a high level of human
epididymis 4 expression in both endometrioid and serous types of endometrial carcinoma ,
these results are consistent with those from other laboratories showing increased human
epididymis protein 4 messenger ribonucleic acid and protein expression in endometrial cancer
tissues.
Subsequent investigation demonstrated that human epididymis protein 4 are detectable in
various normal tissues with varying expression levels, yet their levels are significantly
increased in endometrial carcinoma compared to normal endometrium.
Human epididymis protein 4 ( HE4) is a member of the whey-acidic protein family and it is .
Human epididymis protein 4 was first isolated from the human epididymis .
This protein is also known as epididymal secretory protein E4, major epididymis specific
protein E4 and putative protease inhibitor WAP5. WFDC-2 gene product was originally thought
to be a protein specifically expressed in the epididymis and was dubbed as a tissue marker
for the same.
Angioli etal 2013, found HE4 cutoff of 70pmol/l yields the best sensitivity and specificity
for detecting endometrial cancer (59.4%) sensitivity and 100% specificity) with a positive
predictive value 100% and negative predictive value equal to 71.52% for the 70 pmol/l cutoff,
also found that HE4 marker was never increased in patients with benign diseases Kalogera etal
2012 found that HE4 is elevated in high proportion of endometrial cancer patients and it is
correlated with myometrial invasion (> 50% P< 0.00) also found that lymph node, statue
correlates with the HE4 values there is a statistical significant difference comparing stage
I versus stage III (P < 0.0010).
These findings suggest that HE4 could be useful as a preoperative indicator to identify
patients suitable for pelvic and para aortic lymphadenectomy.
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