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Meta-Analysis
. 2020 Jan-Dec:19:1533033820971660.
doi: 10.1177/1533033820971660.

Role of Human Epididymis Protein 4 (HE4) in Determining Survival of Patients With Endometrial Cancer: A Meta-Analysis

Ying He  1 , Jing Wang  1 , Chun-Xing Ma  1 , Yan-Hua Kang  1
Affiliations
Meta-Analysis

Role of Human Epididymis Protein 4 (HE4) in Determining Survival of Patients With Endometrial Cancer: A Meta-Analysis

Ying He et al. Technol Cancer Res Treat. 2020 Jan-Dec.

Abstract

Background: Human epididymis protein 4 (HE4) is a novel cancer biomarker. This study evaluates the prognostic role of HE4 in determining the survival of endometrial cancer patients.

Methods: Literature search was conducted in electronic databases (Embase, Ovid, PubMed, Scopus, and Web of Science). Studies were selected if they reported the relationship between HE4 and the survival of endometrial cancer patients. Random-effects meta-analyses were performed to achieve estimates of baseline serum HE4 levels, the 5-year survival with high and low serum HE4 levels/expression, and the hazard ratios (HRs) of the survival between patients with high and low serum HE4 levels.

Results: 9 studies (1404 patients; age 63.1 years [95% confidence interval (CI): 61.2, 64.9]; follow-up 35.9 months [95% CI: 32.2, 39.6]) were included. In these patients, serum HE4 levels were 83.36 picomole/liter (pM) [95% CI: 70.15, 96.56] overall but these were higher in patients with recurrence (108.13 pM [95% CI: 63.09, 153.18] and lower in patients with no recurrence (67.88 pM [95% CI: 65.09, 70.67]). The 5-year overall survival rate was higher in patients with low HE4 levels/expression (86% [95% CI: 79, 92] but lower in patients with high HE4 levels/expression (63% [95% CI: 58, 68]. A pooled HR of survival between patients with high and low serum HE4 levels of 2.25 [95% CI: 1.56, 2.94] indicated shorter survival in patients with high serum HE4 levels.

Conclusion: High HE4 concentrations in patients with endometrial cancer are found to be associated with shorter survival.

Keywords: cancer biomarker; endometrial cancer; human epididymis protein 4; survival.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
A flowchart of the study screening and selection process.
Figure 2.
Figure 2.
A forest graph showing the outcomes of the pooled analysis of the serum HE4 levels.
Figure 3.
Figure 3.
A forest graph showing the outcomes of the pooled analysis of the 5-year disease/progression free survival (DFS/PFS) and overall survival (OS) probability in endometrial cancer patients with high and low HE4 levels/expression.
Figure 4.
Figure 4.
A forest graph showing the outcomes of the pooled analysis of the hazard ratios of survival between patients with high vs low serum HE4 levels.
See this image and copyright information in PMC

References

    1. American College of Obstetricians and Gynecologists. Endometrial cancer. Updated February 4, 2019. Accessed July 28, 2019 https://www.acog.org/patient-resources/faqs/gynecologic-problems/endomet...
    1. Purdie DM, Green AC. Epidemiology of endometrial cancer. Best Pract Res Clin Obstet Gynaecol. 2001;15(3):341–354. - PubMed
    1. Braun MM, Overbeek-Wager EA, Grumbo RJ. Diagnosis and management of endometrial cancer. Am Fam Physician. 2016;93(6):468–474. - PubMed
    1. American Cancer Society. Key Statistics for endometrial cancers. Updated July 14, 2019. Accessed August 12, 2019 https://www.cancer.org/cancer/endometrial-cancer/about/key-statistics.html
    1. Murali R, Soslow RA, Weigelt B. Classification of endometrial carcinoma: more than two types. Lancet Oncol. 2014;15(7):e268–278. - PubMed

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