Predictive Value of Serum Cytokeratin 19 Level for the Feasibility of Conserving Ovaries in Endometrial Cancer
Objective: To determine the predictive value of cytokeratin 19 (CK19) for evaluating the safety of ovarian preservation in patients with endometrial cancer (EC).Methods: Five hundred and seventeen EC patients hospitalized from November 2010 to June 2016 were reviewed retrospectively. Pre-operative t...
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Frontiers Media S.A.
2021-08-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2021.670109/full |
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| author | Jie Xu Jie Xu Can Chen Can Chen Jing Xiong Hui Wang Hui Wang Hua Linghu Hua Linghu |
| author_facet | Jie Xu Jie Xu Can Chen Can Chen Jing Xiong Hui Wang Hui Wang Hua Linghu Hua Linghu |
| author_sort | Jie Xu |
| collection | DOAJ |
| description | Objective: To determine the predictive value of cytokeratin 19 (CK19) for evaluating the safety of ovarian preservation in patients with endometrial cancer (EC).Methods: Five hundred and seventeen EC patients hospitalized from November 2010 to June 2016 were reviewed retrospectively. Pre-operative tumor biomarkers including CA125, HE4, CK19, and CA19-9 were obtained. Predictive biomarkers associated with ovarian metastasis were selected using univariate and multivariate Logistic regression. The cut-off values were determined by receiver operating characteristic (ROC) curves. Kaplan-Meier method and Cox multivariate regression model was used to perform survival analysis.Results: Among clinical parameters and biomarkers included, age > 65, type II EC, CA125 ≥ 35 u/ml, CK19 > 3.3 ng/ml, and myometrial invasion ≥ 50% depth appeared as significant predictors of the risk of ovarian involvement in univariable logistic analysis. In multivariable analysis, CK19 > 3.3 ng/ml (OR = 11.541, 95%CI: 1.968–67.668, P = 0.007) and Type II EC (OR = 8.336, 95%CI: 1.456–47.722, P = 0.017) were independent risk predictors of ovarian metastasis in pre-menopausal women. In pre-menopausal women with Type I EC (n = 142), CK19 level could satisfactorily predict the risk of ovarian metastasis (AUC = 0.860, 95%CI: 0.792–0.912, P < 0.001), and when the cut-off point was set as 2.45 ng/ml, the negative predictive value and negative likelihood ratio were 99% and 0.19, with the maximum Youden index of 0.598.Conclusions: The present study advocates the necessity of incorporating serum CK19 measurement into the pre-operative evaluation of EC, especially as extension of current standard approach with ovarian preservation counseling. |
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| publishDate | 2021-08-01 |
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| spelling | doaj.art-003d7a8760a143d08262e2ecb6ef0eec2022-12-21T21:47:40ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2021-08-01810.3389/fmed.2021.670109670109Predictive Value of Serum Cytokeratin 19 Level for the Feasibility of Conserving Ovaries in Endometrial CancerJie Xu0Jie Xu1Can Chen2Can Chen3Jing Xiong4Hui Wang5Hui Wang6Hua Linghu7Hua Linghu8Department of Obstetrics and Gynecology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaThe First Clinical College, Chongqing Medical University, Chongqing, ChinaDepartment of Obstetrics and Gynecology, Chengdu Women and Children's Central Hospital, Chengdu, ChinaSchool of Medicine, University of Electronic Science and Technology of China, Chengdu, ChinaDepartment of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, ChinaDepartment of Obstetrics and Gynecology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaThe First Clinical College, Chongqing Medical University, Chongqing, ChinaDepartment of Obstetrics and Gynecology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaThe First Clinical College, Chongqing Medical University, Chongqing, ChinaObjective: To determine the predictive value of cytokeratin 19 (CK19) for evaluating the safety of ovarian preservation in patients with endometrial cancer (EC).Methods: Five hundred and seventeen EC patients hospitalized from November 2010 to June 2016 were reviewed retrospectively. Pre-operative tumor biomarkers including CA125, HE4, CK19, and CA19-9 were obtained. Predictive biomarkers associated with ovarian metastasis were selected using univariate and multivariate Logistic regression. The cut-off values were determined by receiver operating characteristic (ROC) curves. Kaplan-Meier method and Cox multivariate regression model was used to perform survival analysis.Results: Among clinical parameters and biomarkers included, age > 65, type II EC, CA125 ≥ 35 u/ml, CK19 > 3.3 ng/ml, and myometrial invasion ≥ 50% depth appeared as significant predictors of the risk of ovarian involvement in univariable logistic analysis. In multivariable analysis, CK19 > 3.3 ng/ml (OR = 11.541, 95%CI: 1.968–67.668, P = 0.007) and Type II EC (OR = 8.336, 95%CI: 1.456–47.722, P = 0.017) were independent risk predictors of ovarian metastasis in pre-menopausal women. In pre-menopausal women with Type I EC (n = 142), CK19 level could satisfactorily predict the risk of ovarian metastasis (AUC = 0.860, 95%CI: 0.792–0.912, P < 0.001), and when the cut-off point was set as 2.45 ng/ml, the negative predictive value and negative likelihood ratio were 99% and 0.19, with the maximum Youden index of 0.598.Conclusions: The present study advocates the necessity of incorporating serum CK19 measurement into the pre-operative evaluation of EC, especially as extension of current standard approach with ovarian preservation counseling.https://www.frontiersin.org/articles/10.3389/fmed.2021.670109/fullpre-operative biomarkersCK19ovarian conservationprognostic factorsendometrial cancer |
| spellingShingle | Jie Xu Jie Xu Can Chen Can Chen Jing Xiong Hui Wang Hui Wang Hua Linghu Hua Linghu Predictive Value of Serum Cytokeratin 19 Level for the Feasibility of Conserving Ovaries in Endometrial Cancer Frontiers in Medicine pre-operative biomarkers CK19 ovarian conservation prognostic factors endometrial cancer |
| title | Predictive Value of Serum Cytokeratin 19 Level for the Feasibility of Conserving Ovaries in Endometrial Cancer |
| title_full | Predictive Value of Serum Cytokeratin 19 Level for the Feasibility of Conserving Ovaries in Endometrial Cancer |
| title_fullStr | Predictive Value of Serum Cytokeratin 19 Level for the Feasibility of Conserving Ovaries in Endometrial Cancer |
| title_full_unstemmed | Predictive Value of Serum Cytokeratin 19 Level for the Feasibility of Conserving Ovaries in Endometrial Cancer |
| title_short | Predictive Value of Serum Cytokeratin 19 Level for the Feasibility of Conserving Ovaries in Endometrial Cancer |
| title_sort | predictive value of serum cytokeratin 19 level for the feasibility of conserving ovaries in endometrial cancer |
| topic | pre-operative biomarkers CK19 ovarian conservation prognostic factors endometrial cancer |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2021.670109/full |
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