Abstract
The impact of HE4 and CA125 on lymph node metastasis in endometrial cancer and evaluate the diagnostic effectiveness of these biomarkers when combined with enhanced CT imaging to predict lymph node metastasis. The objective is to examine how HE4 and CA125 influence lymph node metastasis and to assess their diagnostic utility when paired with enhanced CT imaging to predict lymph node involvement in endometrial cancer. The study included 326 patients who underwent surgery for endometrial cancer (experimental group), alongside 98 individuals without cancer (control group). A retrospective analysis was carried out to assess the diagnostic efficacy of HE4 and CA125, in combination with enhanced CT, for predicting lymph node metastasis. Levels of HE4 and CA125 were measured and compared between the experimental and control groups, as well as within the lymph node-positive and -negative groups. Significant variations in HE4 and CA125 levels were found between the endometrial cancer and control groups, and between lymph node-positive and -negative subgroups within the endometrial cancer cohort (p < 0.001). The AUC for HE4 was 0.73 (p < 0.001) in premenopausal and 0.578 (p = 0.164) in postmenopausal groups. For CA125, the AUC was 0.81 (p < 0.001) in premenopausal and 0.671 (p = 0.002) in postmenopausal groups. Cut-off concentrations to predict lymph node metastasis: Premenopausal - HE4 = 52.95 pmol/l, CA125 = 69.45 U/ml; Postmenopausal - HE4 = 69.15pmol/l, CA125 = 21.45 U/ml. Combining enhanced CT imaging with HE4 and CA125 improved diagnostic accuracy compared to individual tests. In conclusion, the study offers valuable insights into the potential usefulness of HE4 and CA125, in conjunction with enhanced CT imaging, for diagnosing and predicting lymph node metastasis in patients with endometrial cancer.