The effectiveness of CA125 and HE4 as clinical prognostic markers in epithelial ovarian cancer patients with BRCA mutation
To investigate the efficacy of cancer antigen 125 (CA125) and human epididymis protein 4 (HE4) in predicting survival outcomes based on breast cancer gene (BRCA) mutational status in epithelial ovarian cancer. Medical records of 448 patients diagnosed with epithelial ovarian cancer at a single terti...
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| Published in | Journal of gynecologic oncology Vol. 35; no. 6; pp. e80 - 12 |
|---|---|
| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Korea (South)
Asian Society of Gynecologic Oncology; Korean Society of Gynecologic Oncology; Japan Society of Gynecologic Oncology
01.11.2024
대한부인종양학회 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 2005-0380 2005-0399 2005-0399 |
| DOI | 10.3802/jgo.2024.35.e80 |
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| Abstract | To investigate the efficacy of cancer antigen 125 (CA125) and human epididymis protein 4 (HE4) in predicting survival outcomes based on breast cancer gene (BRCA) mutational status in epithelial ovarian cancer.
Medical records of 448 patients diagnosed with epithelial ovarian cancer at a single tertiary institution in Korea were retrospectively analyzed. Area under the curve, sensitivity, specificity, and accuracy were assessed using the CA125 and HE4 values after surgery and 3 cycles of chemotherapy to predict 1-year survival based on the BRCA mutational status. Kaplan-Meier analysis was used to obtain progression-free and overall survival to evaluate CA125 and HE4 effectiveness in predicting survival outcomes.
A total of 423 patients were analyzed, including 180 (42.6%) who underwent interval debulking surgery (IDS) and 243 (57.4%) who underwent primary debulking surgery (PDS). BRCA mutations were observed in 37 (15.2%) and 44 (22.4%) patients in the PDS and IDS groups, respectively. CA125 and HE4 normalization demonstrated the highest specificity in patients with or without BRCA mutations, with specificities of 97.1% and 99.1% in the PDS group and 78.6% and 86.2% in the IDS group, respectively. Normalizing HE4 alone may be an effective prognostic marker, with an area under the curve of 0.774 and specificity of 75.0%, in patients with BRCA mutations.
Normalizing both biomarkers emerged as the most effective predictive marker for the 1-year recurrence rate, regardless of BRCA mutational status. A negative HE4 value can be a useful predictor for 1-year recurrence-free survival in patients with BRCA mutations. |
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| AbstractList | To investigate the efficacy of cancer antigen 125 (CA125) and human epididymis protein 4 (HE4) in predicting survival outcomes based on breast cancer gene (BRCA) mutational status in epithelial ovarian cancer.OBJECTIVETo investigate the efficacy of cancer antigen 125 (CA125) and human epididymis protein 4 (HE4) in predicting survival outcomes based on breast cancer gene (BRCA) mutational status in epithelial ovarian cancer.Medical records of 448 patients diagnosed with epithelial ovarian cancer at a single tertiary institution in Korea were retrospectively analyzed. Area under the curve, sensitivity, specificity, and accuracy were assessed using the CA125 and HE4 values after surgery and 3 cycles of chemotherapy to predict 1-year survival based on the BRCA mutational status. Kaplan-Meier analysis was used to obtain progression-free and overall survival to evaluate CA125 and HE4 effectiveness in predicting survival outcomes.METHODSMedical records of 448 patients diagnosed with epithelial ovarian cancer at a single tertiary institution in Korea were retrospectively analyzed. Area under the curve, sensitivity, specificity, and accuracy were assessed using the CA125 and HE4 values after surgery and 3 cycles of chemotherapy to predict 1-year survival based on the BRCA mutational status. Kaplan-Meier analysis was used to obtain progression-free and overall survival to evaluate CA125 and HE4 effectiveness in predicting survival outcomes.A total of 423 patients were analyzed, including 180 (42.6%) who underwent interval debulking surgery (IDS) and 243 (57.4%) who underwent primary debulking surgery (PDS). BRCA mutations were observed in 37 (15.2%) and 44 (22.4%) patients in the PDS and IDS groups, respectively. CA125 and HE4 normalization demonstrated the highest specificity in patients with or without BRCA mutations, with specificities of 97.1% and 99.1% in the PDS group and 78.6% and 86.2% in the IDS group, respectively. Normalizing HE4 alone may be an effective prognostic marker, with an area under the curve of 0.774 and specificity of 75.0%, in patients with BRCA mutations.RESULTSA total of 423 patients were analyzed, including 180 (42.6%) who underwent interval debulking surgery (IDS) and 243 (57.4%) who underwent primary debulking surgery (PDS). BRCA mutations were observed in 37 (15.2%) and 44 (22.4%) patients in the PDS and IDS groups, respectively. CA125 and HE4 normalization demonstrated the highest specificity in patients with or without BRCA mutations, with specificities of 97.1% and 99.1% in the PDS group and 78.6% and 86.2% in the IDS group, respectively. Normalizing HE4 alone may be an effective prognostic marker, with an area under the curve of 0.774 and specificity of 75.0%, in patients with BRCA mutations.Normalizing both biomarkers emerged as the most effective predictive marker for the 1-year recurrence rate, regardless of BRCA mutational status. A negative HE4 value can be a useful predictor for 1-year recurrence-free survival in patients with BRCA mutations.CONCLUSIONNormalizing both biomarkers emerged as the most effective predictive marker for the 1-year recurrence rate, regardless of BRCA mutational status. A negative HE4 value can be a useful predictor for 1-year recurrence-free survival in patients with BRCA mutations. To investigate the efficacy of cancer antigen 125 (CA125) and human epididymis protein 4 (HE4) in predicting survival outcomes based on breast cancer gene (BRCA) mutational status in epithelial ovarian cancer. Medical records of 448 patients diagnosed with epithelial ovarian cancer at a single tertiary institution in Korea were retrospectively analyzed. Area under the curve, sensitivity, specificity, and accuracy were assessed using the CA125 and HE4 values after surgery and 3 cycles of chemotherapy to predict 1-year survival based on the BRCA mutational status. Kaplan-Meier analysis was used to obtain progression-free and overall survival to evaluate CA125 and HE4 effectiveness in predicting survival outcomes. A total of 423 patients were analyzed, including 180 (42.6%) who underwent interval debulking surgery (IDS) and 243 (57.4%) who underwent primary debulking surgery (PDS). BRCA mutations were observed in 37 (15.2%) and 44 (22.4%) patients in the PDS and IDS groups, respectively. CA125 and HE4 normalization demonstrated the highest specificity in patients with or without BRCA mutations, with specificities of 97.1% and 99.1% in the PDS group and 78.6% and 86.2% in the IDS group, respectively. Normalizing HE4 alone may be an effective prognostic marker, with an area under the curve of 0.774 and specificity of 75.0%, in patients with BRCA mutations. Normalizing both biomarkers emerged as the most effective predictive marker for the 1-year recurrence rate, regardless of BRCA mutational status. A negative HE4 value can be a useful predictor for 1-year recurrence-free survival in patients with BRCA mutations. This study is the first to assess cancer antigen 125 (CA125) and human epididymis protein 4 (HE4) efficacy in predicting recurrence in patients with breast cancer gene (BRCA) mutation. Normalizing biomarkers is the most predictive for 1-year recurrence rate. Negative HE4 predicts 1-year recurrence-free survival in patients with BRCA mutations. Objective: To investigate the efficacy of cancer antigen 125 (CA125) and human epididymisprotein 4 (HE4) in predicting sur vival outcomes based on breast cancer gene (BRCA)mutational status in epithelial ovarian cancer. Methods: Medical records of 448 patients diagnosed with epithelial ovarian cancer at a singletertiar y institution in Korea were retrospectively analyzed. Area under the cur ve, sensitivity,specificity, and accuracy were assessed using the CA125 and HE4 values after surger y and3 cycles of chemotherapy to predict 1-year sur vival based on the BRCA mutational status. Kaplan–Meier analysis was used to obtain progression-free and overall sur vival to evaluateCA125 and HE4 effectiveness in predicting sur vival outcomes. Results: A total of 423 patients were analyzed, including 180 (42.6%) who under went inter valdebulking surger y (IDS) and 243 (57.4%) who under went primar y debulking surger y (PDS). BRCA mutations were obser ved in 37 (15.2%) and 44 (22.4%) patients in the PDS and IDSgroups, respectively. CA125 and HE4 normalization demonstrated the highest specificity inpatients with or without BRCA mutations, with specificities of 97.1% and 99.1% in the PDSgroup and 78.6% and 86.2% in the IDS group, respectively. Normalizing HE4 alone may be aneffective prognostic marker, with an area under the cur ve of 0.774 and specificity of 75.0%, inpatients with BRCA mutations. Conclusion: Normalizing both biomarkers emerged as the most effective predictive markerfor the 1-year recurrence rate, regardless of BRCA mutational status. A negative HE4 value canbe a useful predictor for 1-year recurrence-free sur vival in patients with BRCA mutations. KCI Citation Count: 1 |
| Author | Lee, Young Joo Kim, Sang Wun Lee, Jung-Yun Kim, Young Tae Hong, Soomin Lee, Yong Jae Kim, Sunghoon Nam, Eun Ji Kim, Woojin |
| AuthorAffiliation | 2 Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea 3 Korea Medical Institute, Seoul, Korea 1 Department of Obstetrics and Gynecology, Women’s Cancer Center, Yonsei Cancer Center, Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul, Korea |
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| Copyright | 2024. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology, and Japan Society of Gynecologic Oncology. 2024. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology, and Japan Society of Gynecologic Oncology 2024 Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology, and Japan Society of Gynecologic Oncology |
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| Keywords | BRCA2 Protein Carcinoma, Ovarian Epithelial CA-125 Antigen BRCA1 Protein Biomarkers, Tumor |
| Language | English |
| License | 2024. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology, and Japan Society of Gynecologic Oncology. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
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| References_xml | – volume: 24 start-page: 1359 year: 2014 ident: 10.3802/jgo.2024.35.e80_ref8 publication-title: Int J Gynecol Cancer doi: 10.1097/IGC.0000000000000218 – volume: 14 start-page: 9 year: 2017 ident: 10.3802/jgo.2024.35.e80_ref1 publication-title: Cancer Biol Med doi: 10.20892/j.issn.2095-3941.2016.0084 – volume: 21 start-page: 547 year: 2017 ident: 10.3802/jgo.2024.35.e80_ref22 publication-title: Genet Test Mol Biomarkers doi: 10.1089/gtmb.2017.0104 – volume: 474 start-page: 609 year: 2011 ident: 10.3802/jgo.2024.35.e80_ref17 publication-title: Nature doi: 10.1038/nature10166 – volume: 14 start-page: 5833 year: 2008 ident: 10.3802/jgo.2024.35.e80_ref4 publication-title: Clin Cancer Res doi: 10.1158/1078-0432.CCR-08-0819 – volume: 41 start-page: 31 year: 2017 ident: 10.3802/jgo.2024.35.e80_ref20 publication-title: Best Pract Res Clin Obstet Gynaecol doi: 10.1016/j.bpobgyn.2016.10.017 – volume: 14 start-page: 5734 year: 2022 ident: 10.3802/jgo.2024.35.e80_ref5 publication-title: Cancers (Basel) doi: 10.3390/cancers14235734 – volume: 100 start-page: 1315 year: 2009 ident: 10.3802/jgo.2024.35.e80_ref9 publication-title: Br J Cancer doi: 10.1038/sj.bjc.6605011 – volume: 139 start-page: 59 year: 2020 ident: 10.3802/jgo.2024.35.e80_ref23 publication-title: Eur J Cancer doi: 10.1016/j.ejca.2020.08.021 – volume: 33 start-page: 382 year: 2012 ident: 10.3802/jgo.2024.35.e80_ref11 publication-title: Eur J Gynaecol Oncol – volume: 26 start-page: 1586 year: 2016 ident: 10.3802/jgo.2024.35.e80_ref16 publication-title: Int J Gynecol Cancer doi: 10.1097/IGC.0000000000000804 – volume: 59 start-page: 1954 year: 2021 ident: 10.3802/jgo.2024.35.e80_ref14 publication-title: Clin Chem Lab Med doi: 10.1515/cclm-2021-0510 – volume: 21 start-page: 1573 year: 2011 ident: 10.3802/jgo.2024.35.e80_ref12 publication-title: Int J Gynecol Cancer doi: 10.1097/IGC.0b013e3182225509 – volume: 32 start-page: 153 year: 2022 ident: 10.3802/jgo.2024.35.e80_ref28 publication-title: Int J Gynecol Cancer doi: 10.1136/ijgc-2021-003053 – volume: 309 start-page: 883 year: 1983 ident: 10.3802/jgo.2024.35.e80_ref24 publication-title: N Engl J Med doi: 10.1056/NEJM198310133091503 – volume: 20 start-page: 952 year: 2019 ident: 10.3802/jgo.2024.35.e80_ref2 publication-title: Int J Mol Sci doi: 10.3390/ijms20040952 – volume: 62 start-page: 288 year: 2021 ident: 10.3802/jgo.2024.35.e80_ref3 publication-title: Yonsei Med J doi: 10.3349/ymj.2021.62.4.288 – volume: 108 start-page: 402 year: 2008 ident: 10.3802/jgo.2024.35.e80_ref25 publication-title: Gynecol Oncol doi: 10.1016/j.ygyno.2007.10.017 – volume: 25 start-page: 445 year: 2020 ident: 10.3802/jgo.2024.35.e80_ref29 publication-title: Expert Opin Emerg Drugs doi: 10.1080/14728214.2020.1836155 – volume: 50 start-page: 160 year: 2023 ident: 10.3802/jgo.2024.35.e80_ref15 publication-title: Clin Exp Obstet Gynecol doi: 10.31083/j.ceog5008160 – volume: 131 start-page: 52 year: 2013 ident: 10.3802/jgo.2024.35.e80_ref27 publication-title: Gynecol Oncol doi: 10.1016/j.ygyno.2013.07.094 – volume: 27 start-page: 1483 year: 2018 ident: 10.3802/jgo.2024.35.e80_ref7 publication-title: Cancer Epidemiol Biomarkers Prev doi: 10.1158/1055-9965.EPI-18-0203 – volume: 62 start-page: 1090 year: 2021 ident: 10.3802/jgo.2024.35.e80_ref19 publication-title: Yonsei Med J doi: 10.3349/ymj.2021.62.12.1090 – volume: 9 start-page: 55 year: 2021 ident: 10.3802/jgo.2024.35.e80_ref18 publication-title: Biomedicines doi: 10.3390/biomedicines9010055 – volume: 217 start-page: 334.e1 year: 2017 ident: 10.3802/jgo.2024.35.e80_ref26 publication-title: Am J Obstet Gynecol doi: 10.1016/j.ajog.2017.05.036 – volume: 9 start-page: 61 year: 2016 ident: 10.3802/jgo.2024.35.e80_ref6 publication-title: J Ovarian Res doi: 10.1186/s13048-016-0270-7 – volume: 17 start-page: 827 year: 2017 ident: 10.3802/jgo.2024.35.e80_ref10 publication-title: Expert Rev Anticancer Ther doi: 10.1080/14737140.2017.1360138 – volume: 206 start-page: 349.e1 year: 2012 ident: 10.3802/jgo.2024.35.e80_ref13 publication-title: Am J Obstet Gynecol doi: 10.1016/j.ajog.2011.12.028 – volume: 68 start-page: 284 year: 2018 ident: 10.3802/jgo.2024.35.e80_ref21 publication-title: CA Cancer J Clin doi: 10.3322/caac.21456 |
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| Snippet | To investigate the efficacy of cancer antigen 125 (CA125) and human epididymis protein 4 (HE4) in predicting survival outcomes based on breast cancer gene... This study is the first to assess cancer antigen 125 (CA125) and human epididymis protein 4 (HE4) efficacy in predicting recurrence in patients with breast... Objective: To investigate the efficacy of cancer antigen 125 (CA125) and human epididymisprotein 4 (HE4) in predicting sur vival outcomes based on breast... |
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| SubjectTerms | Adult Aged Biomarkers, Tumor - blood Biomarkers, Tumor - genetics BRCA1 Protein - genetics CA-125 Antigen - blood Carcinoma, Ovarian Epithelial - blood Carcinoma, Ovarian Epithelial - genetics Carcinoma, Ovarian Epithelial - mortality Carcinoma, Ovarian Epithelial - pathology Carcinoma, Ovarian Epithelial - surgery Cytoreduction Surgical Procedures Female Genes, BRCA1 Humans Membrane Proteins - blood Membrane Proteins - genetics Middle Aged Mutation Original Ovarian Neoplasms - blood Ovarian Neoplasms - genetics Ovarian Neoplasms - mortality Prognosis Proteins - genetics Retrospective Studies WAP Four-Disulfide Core Domain Protein 2 - analysis WAP Four-Disulfide Core Domain Protein 2 - genetics 산부인과학 |
| Title | The effectiveness of CA125 and HE4 as clinical prognostic markers in epithelial ovarian cancer patients with BRCA mutation |
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