Open Access

Identification of high-risk patients by human epididymis protein 4 levels during follow-up of ovarian cancer

  • Authors:
    • Karina Dahl Steffensen
    • Marianne Waldstrøm
    • Ivan Brandslund
    • Bente Lund
    • Sarah Mejer Sørensen
    • Max Petzold
    • Anders Jakobsen
  • View Affiliations

  • Published online on: May 6, 2016     https://doi.org/10.3892/ol.2016.4533
  • Pages: 3967-3974
  • Copyright: © Steffensen et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The majority of ovarian cancer patients with advanced disease at diagnosis will relapse following primary treatment, with a dismal prognosis. Monitoring the levels of serum markers in patients under follow‑up may be essential for the early detection of relapse, and for distinguishing high‑risk patients from those with less aggressive disease. The aim of the present study was to investigate the possible predictive value of human epididymis protein 4 (HE4) and carbohydrate antigen 125 (CA125) in relation to recurrence of epithelial ovarian cancer by measuring the two markers during follow‑up subsequent to surgery and adjuvant first‑line carboplatin/paclitaxel chemotherapy. Serum HE4 and CA125 were analyzed in 88 epithelial ovarian cancer patients at the end of treatment and consecutively during follow‑up. The patients were divided into a high‑risk and a low‑risk group based on having an increase in HE4 and CA125 levels above or below 50% during follow‑up, relative to the baseline (end‑of‑treatment) level. Disease recurrence was detected in 55 patients during follow‑up. Patients with an increase in HE4 of >50% at 3‑ and 6‑month follow‑up compared to the end‑of‑treatment sample had significantly poorer progression‑free survival (PFS) [hazard ratio (HR), 2.82 (95% CI, 0.91‑8.79; P=0.0052) and HR, 7.71 (95% CI, 3.03‑19.58; P<0.0001), respectively]. The corresponding 3‑ and 6‑month biomarker assessments for increased CA125 levels (>50%) showed HRs of 1.86 (95% CI, 0.90‑3.80; P=0.0512) and 2.55 (95% CI, 1.39‑4.68; P=0.0011), respectively. Multivariate analysis confirmed HE4 as a predictor of short PFS, with an HR of 8.23 (95% CI, 3.28‑20.9; P<0.0001) at 6‑month follow‑up. The increase of CA125 was not a significant prognostic factor in multivariate analysis for PFS. In conclusion, HE4 appears to be a sensitive marker of recurrence and instrumental in risk assessment during the first 6 months of follow‑up.
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June-2016
Volume 11 Issue 6

Print ISSN: 1792-1074
Online ISSN:1792-1082

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Spandidos Publications style
Steffensen KD, Waldstrøm M, Brandslund I, Lund B, Sørensen SM, Petzold M and Jakobsen A: Identification of high-risk patients by human epididymis protein 4 levels during follow-up of ovarian cancer. Oncol Lett 11: 3967-3974, 2016
APA
Steffensen, K.D., Waldstrøm, M., Brandslund, I., Lund, B., Sørensen, S.M., Petzold, M., & Jakobsen, A. (2016). Identification of high-risk patients by human epididymis protein 4 levels during follow-up of ovarian cancer. Oncology Letters, 11, 3967-3974. https://doi.org/10.3892/ol.2016.4533
MLA
Steffensen, K. D., Waldstrøm, M., Brandslund, I., Lund, B., Sørensen, S. M., Petzold, M., Jakobsen, A."Identification of high-risk patients by human epididymis protein 4 levels during follow-up of ovarian cancer". Oncology Letters 11.6 (2016): 3967-3974.
Chicago
Steffensen, K. D., Waldstrøm, M., Brandslund, I., Lund, B., Sørensen, S. M., Petzold, M., Jakobsen, A."Identification of high-risk patients by human epididymis protein 4 levels during follow-up of ovarian cancer". Oncology Letters 11, no. 6 (2016): 3967-3974. https://doi.org/10.3892/ol.2016.4533