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High preoperative blood levels of HE4 predicts poor prognosis in patients with ovarian cancer

Kalapotharakos, Grigorios LU ; Asciutto, Christine; Henic, Emir LU ; Casslén, Bertil LU and Borgfeldt, Christer LU (2012) In Journal of Ovarian Research 5.
Abstract
The aim of this study was to assess the clinical value of preoperative blood levels of HE4 as a predictor of overall survival in patients with ovarian cancer and to validate previous data of HE4 and the ROMA algorithm including HE4 and CA125 in discriminating benign and malignant ovarian tumors. Experimental design: The preoperative plasma levels of HE4 and CA125 were analyzed with ELISA in 312 patients with adnexal lesions. Tumors were classified as benign (n= 206), borderline (i.e. low malignant potential tumors) (n= 25), and well (n= 14), moderately (n= 15), and poorly (n= 51) differentiated malignant. Results: In univariate Cox regression analyses high levels (dichotomized at the median) of HE4, CA125, increased age (continuous... (More)
The aim of this study was to assess the clinical value of preoperative blood levels of HE4 as a predictor of overall survival in patients with ovarian cancer and to validate previous data of HE4 and the ROMA algorithm including HE4 and CA125 in discriminating benign and malignant ovarian tumors. Experimental design: The preoperative plasma levels of HE4 and CA125 were analyzed with ELISA in 312 patients with adnexal lesions. Tumors were classified as benign (n= 206), borderline (i.e. low malignant potential tumors) (n= 25), and well (n= 14), moderately (n= 15), and poorly (n= 51) differentiated malignant. Results: In univariate Cox regression analyses high levels (dichotomized at the median) of HE4, CA125, increased age (continuous variable), advanced-stage of disease 2-4, histological grade 3 and non-optimal tumor debulking at primary surgery were all significantly associated with shorter overall survival. A multivariate Cox regression model including pre-operative available covariates HE4 and CA125 both dichotomized at median in addition to age as continuous variable showed that high levels of HE4 was an independent prognostic marker for worse prognosis HR 2.02 (95% CI 1.1-3.8). In postmenopausal women the ROMA algorithm gave the highest AUC of 0.94 (95% CI, 0.90-0.97) which was higher than the separate markers HE4 AUC 0.91 (95% CI 0.86-0.95) and CA125 AUC 0.91(95% CI 0.87-0.96). Conclusions: High concentration of plasma HE4 is an independent preoperative marker of poor prognosis in patients with ovarian cancer. The algorithm ROMA discriminates in postmenopausal women between malignant and benign tumors with an AUC of 0.94. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
HE4, ROMA, Ovarian neoplasm, Survival analyses, Prognosis
in
Journal of Ovarian Research
volume
5
publisher
BioMed Central
external identifiers
  • wos:000310266700001
  • scopus:84865071868
ISSN
1757-2215
DOI
10.1186/1757-2215-5-20
language
English
LU publication?
yes
id
e0c83414-4f89-4790-8154-cd0b2985383e (old id 3287914)
date added to LUP
2013-01-07 09:44:27
date last changed
2017-10-08 03:52:40
@article{e0c83414-4f89-4790-8154-cd0b2985383e,
  abstract     = {The aim of this study was to assess the clinical value of preoperative blood levels of HE4 as a predictor of overall survival in patients with ovarian cancer and to validate previous data of HE4 and the ROMA algorithm including HE4 and CA125 in discriminating benign and malignant ovarian tumors. Experimental design: The preoperative plasma levels of HE4 and CA125 were analyzed with ELISA in 312 patients with adnexal lesions. Tumors were classified as benign (n= 206), borderline (i.e. low malignant potential tumors) (n= 25), and well (n= 14), moderately (n= 15), and poorly (n= 51) differentiated malignant. Results: In univariate Cox regression analyses high levels (dichotomized at the median) of HE4, CA125, increased age (continuous variable), advanced-stage of disease 2-4, histological grade 3 and non-optimal tumor debulking at primary surgery were all significantly associated with shorter overall survival. A multivariate Cox regression model including pre-operative available covariates HE4 and CA125 both dichotomized at median in addition to age as continuous variable showed that high levels of HE4 was an independent prognostic marker for worse prognosis HR 2.02 (95% CI 1.1-3.8). In postmenopausal women the ROMA algorithm gave the highest AUC of 0.94 (95% CI, 0.90-0.97) which was higher than the separate markers HE4 AUC 0.91 (95% CI 0.86-0.95) and CA125 AUC 0.91(95% CI 0.87-0.96). Conclusions: High concentration of plasma HE4 is an independent preoperative marker of poor prognosis in patients with ovarian cancer. The algorithm ROMA discriminates in postmenopausal women between malignant and benign tumors with an AUC of 0.94.},
  author       = {Kalapotharakos, Grigorios and Asciutto, Christine and Henic, Emir and Casslén, Bertil and Borgfeldt, Christer},
  issn         = {1757-2215},
  keyword      = {HE4,ROMA,Ovarian neoplasm,Survival analyses,Prognosis},
  language     = {eng},
  publisher    = {BioMed Central},
  series       = {Journal of Ovarian Research},
  title        = {High preoperative blood levels of HE4 predicts poor prognosis in patients with ovarian cancer},
  url          = {http://dx.doi.org/10.1186/1757-2215-5-20},
  volume       = {5},
  year         = {2012},
}