Abstract
Objective: To investigate serum human epididymis-4 (HE4) as a predictive biomarker of intrauterine progestin response in endometrial cancer and atypical endometrial hyperplasia (AEH).
Design: Prospective prognostic factor study.
Setting: Consecutive sample of women attending a tertiary gynaecological oncology centre in the North West of England.
Population: Women with AEH or early stage, low grade endometrial cancer who were unfit or declined primary surgical management.
Methods: A total of 76 women, 32 with AEH and 44 with endometrial cancer, were treated with a levonorgestrel intrauterine system (LNG-IUS) for 12 months. Endometrial biopsies and imaging were performed to assess treatment response. Pre-treatment serum HE4 was analysed by chemiluminescence immunoassay and diagnostic accuracy and logistic regression analyses performed.
Main outcome measure: Progestin response at 12 months defined by histology and imaging.
Results: The median age and BMI of the final cohort were 52 years (IQR:33-62) and 46kg/m2 (IQR:38-54), respectively. Baseline serum HE4 was significantly higher in non-responders than responders [119.2pmol/L (IQR:94.0-208.4) vs 71.8pmol/L (IQR:56.1-84.2), pConclusion: Serum HE4 shows promise as a predictive biomarker of progestin treatment response in endometrial cancer and AEH.
Design: Prospective prognostic factor study.
Setting: Consecutive sample of women attending a tertiary gynaecological oncology centre in the North West of England.
Population: Women with AEH or early stage, low grade endometrial cancer who were unfit or declined primary surgical management.
Methods: A total of 76 women, 32 with AEH and 44 with endometrial cancer, were treated with a levonorgestrel intrauterine system (LNG-IUS) for 12 months. Endometrial biopsies and imaging were performed to assess treatment response. Pre-treatment serum HE4 was analysed by chemiluminescence immunoassay and diagnostic accuracy and logistic regression analyses performed.
Main outcome measure: Progestin response at 12 months defined by histology and imaging.
Results: The median age and BMI of the final cohort were 52 years (IQR:33-62) and 46kg/m2 (IQR:38-54), respectively. Baseline serum HE4 was significantly higher in non-responders than responders [119.2pmol/L (IQR:94.0-208.4) vs 71.8pmol/L (IQR:56.1-84.2), pConclusion: Serum HE4 shows promise as a predictive biomarker of progestin treatment response in endometrial cancer and AEH.
| Original language | English |
|---|---|
| Journal | British Journal of Obstetrics and Gyanecology |
| Publication status | Accepted/In press - 4 Jan 2023 |
Keywords
- HE4
- prediction
- biomarker
- therapy
- response
- endometrial cancer
- atypical endometrial hyperplasia
- intrauterine progestin
