Diagnostic and prognostic values of preoperative serum levels of YKL-40, HE-4 and DKK-3 in endometrial cancer

Abstract Objective The objective of this study is to determine the efficiency of YKL-40, HE-4 and DKK-3 levels in early diagnosis of patients with endometrial cancer and in the pre-operative estimation of the prognostic parameters such as stage, grade and the extension of the disease. Methods In thi...

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Published in:Gynecologic oncology 2016-01, Vol.140 (1), p.64-69
Main Authors: Kemik, Pınar, Saatli, Bahadır, Yıldırım, Nuri, Kemik, Vahit Doğu, Deveci, Banu, Terek, Mustafa Coşan, Koçtürk, Semra, Koyuncuoğlu, Meral, Saygılı, Uğur
Format: Article
Language:English
Subjects:
Adipokines - blood
Aged
Aged, 80 and over
Animals
Biomarkers, Tumor - blood
CA-125 Antigen - blood
Case-Control Studies
Chitinase-3-Like Protein 1
DKK-3
Endometrial cancer
Endometrial Neoplasms - blood
Female
HE-4
Hematology, Oncology and Palliative Medicine
Humans
Intercellular Signaling Peptides and Proteins - blood
Lectins - blood
Membrane Proteins - blood
Middle Aged
Obstetrics and Gynecology
Prognosis
Prognostic factors
Prospective Studies
Proteins - metabolism
Tumor markers
YKL-40
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Summary:Abstract Objective The objective of this study is to determine the efficiency of YKL-40, HE-4 and DKK-3 levels in early diagnosis of patients with endometrial cancer and in the pre-operative estimation of the prognostic parameters such as stage, grade and the extension of the disease. Methods In this prospective study, 50 patients diagnosed with endometrial cancer and 50 women as a control group, who applied to Dokuz Eylul University and Ege University Faculties of Medicine, Obstetrics and Gynecology Clinics between May 2011–May 2012 were included. CA125, HE-4, YKL-40 and DKK-3 serum levels were measured by ELISA and compared between two groups. The relation between serum levels and histopathological results, extension of disease and prognostic factors were analyzed. Results Preoperative serum CA125, HE-4 and YKL-40 levels were significantly higher in endometrial cancer group (p < 0.001). Serum HE-4 levels were significantly higher in advanced stages (p = 0.004). When we examined early stage patients, YKL-40 levels were significantly higher in non-endometrioid histology compared with endometrioid adenocarcinoma (p = 0.022). We also examined the relation between the markers and prognostic factors. Different from other markers, HE-4 levels were significantly higher in endometrial cancer patients who had lymphovascular space involvement, lower uterine segment involvement, endocervical stromal involvement, and deep myometrial invasion. Conclusion YKL-40 and HE-4 were significantly higher in patients with endometrial cancer. HE-4 seems to be superior to YKL-40 in discriminating early and advanced stages. Additionally, HE4 is significantly correlated with prognostic factors. HE-4 and YKL-40 may be successful in early determination of endometrial cancer and in detection of high risk subsets before surgery.
ISSN:0090-8258
1095-6859
DOI:10.1016/j.ygyno.2015.11.020