Value of tumor volume to uterine volume ratio combined with serum AFP, CA199, HE4 expression in evaluating pathological grade and prognosis of endometrial carcinoma
10.3760/cma.j.cn115807-20250107-00016
- VernacularTitle:子宫内膜癌肿瘤体积与子宫体积比值联合血清AFP、CA199、HE4的表达对病理分级和预后的评估价值
- Author:
Chengxiang HUANG
1
;
Cui LI
1
;
Haitang ZHANG
1
;
Yujuan LI
1
;
Yanfen DAI
1
;
Hongyun LIU
1
Author Information
1. 临沂市中心医院妇科，临沂 276400
- Publication Type:Journal Article
- Keywords:
Endometrial cancer;
Ratio of tumor volume to uterine volume;
Alpha-fetoprotein;
Carbohydrate antigen 199;
Human epididymal secretory protein 4;
Pathologica
- From:
Chinese Journal of Endocrine Surgery
2025;19(4):589-594
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the value of tumor volume to uterine volume ratio (N/U) combined with the expression of alpha-fetoprotein (AFP), sugar antigen 199 (CA199) and human epididymal secretory protein 4 (HE4) in evaluating the pathologic grade and prognosis of endometrial carcinoma (EC) .Methods:A total of 160 EC patients admitted to Linyi Central Hospital from Jan. 2021 to Dec. 2023 were divided into low-grade group and high-grade group according to FIGO grading method, and were divided into poor prognosis group and good prognosis group according to cancer death, recrudescence. The levels of N/U, AFP, CA199 and HE4 in patients with different pathologic grades and prognosis were compared. COX regression was used to analyze the influencing factors of EC adverse prognosis, ROC curve was used to analyze the value of N/U combined with serum AFP, CA199 and HE4 in predicting EC adverse prognosis, and a nomogram model was constructed.Results:Pathological examination of 160 EC patients showed that 12 cases were non-endometrioid adenocarcinoma, 148 cases were endometrioid adenocarcinoma, 41 cases were high-grade and 119 cases were low-grade.According to the follow-up, 94 of the 160 EC patients had good prognosis and 66 had poor prognosis. The levels of N/U, AFP, CA199 and HE4 in the poor prognosis group were higher than those in the good prognosis group ( P<0.05). COX regression analysis showed that high levels of N/U, AFP, CA199 and HE4 were all factors affecting the poor prognosis of EC patients ( P<0.05). The AUC value of combined detection of N/U, AFP, CA199 and HE4 in predicting adverse prognosis of EC patients was higher than that of single detection ( Z=3.140, 3.658, 4.277, 4.378, P<0.05) .The ROC curve AUC (95% CI) of the training set and the validation set were 0.84 (0.77-0.92) and 0.90 (0.81-0.98) respectively for the training set and the validation set to predict the adverse prognosis of EC patients. Calibration curve results showed that the calibration curve for EC patients predicted by the nomogram model was close to the ideal curve ( P=0.521, 0.743). The DCA curve shows that the probability threshold of the nomogram model has a higher positive net return at 20%~100%. Conclusion:The levels of N/U, AFP, CA199 and HE4 in EC patients are related to the pathologic grade, and the combined detection of these indicators can predict the poor prognosis of EC patients, and the nomogram model constructed based on these indicators has high predictive value.
