Evaluation of He4 Use in the Diagnosis of Ovarian Cancer: First and Second Recurrence, and an Analysis of HE4 Concentration during Second- and Third-Line Chemotherapy
HE4 is a commonly used tumor marker for ovarian cancer (OC) diagnosis. In our study, we aimed to assess its use in the diagnosis of subsequent OC recurrences and to evaluate its changes during recurrence diagnosis and the subsequent lines of chemotherapy treatment. This retrospective single center s...
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MDPI AG
2023-01-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/13/3/452 |
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| author | Anita Chudecka-Głaz Aleksandra Strojna Kaja Michalczyk Sylwia Wieder-Huszla Krzysztof Safranow Edyta Skwirczyńska Anna Jurczak |
| author_facet | Anita Chudecka-Głaz Aleksandra Strojna Kaja Michalczyk Sylwia Wieder-Huszla Krzysztof Safranow Edyta Skwirczyńska Anna Jurczak |
| author_sort | Anita Chudecka-Głaz |
| collection | DOAJ |
| description | HE4 is a commonly used tumor marker for ovarian cancer (OC) diagnosis. In our study, we aimed to assess its use in the diagnosis of subsequent OC recurrences and to evaluate its changes during recurrence diagnosis and the subsequent lines of chemotherapy treatment. This retrospective single center study was conducted on 188 patients treated for ovarian cancer recurrence at the Department of Gynecological Surgery and Gynecological Oncology. The sensitivity and specificity of HE4 for patient survival prediction were analyzed using Receiver Operating Characteristics (ROC) and area under the curve (AUC) with 95% confidence intervals (95% CI). Survival times to reach one of the endpoints (OS, PFS, TFI, PFS2, TFI2) were analyzed using Kaplan–Meier curves. Elevated HE4 levels at the time of first relapse diagnosis, and after the third and the last course of second-line chemotherapy, significantly influences the time from OC diagnosis until first disease recurrence (PFS2) (<i>p </i>= 0.005, <i>p </i>= 0.015 and <i>p </i>= 0.002, respectively). Additionally, elevated serum HE4 concentration at the time of OC diagnosis (<i>p </i>= 0.012), and its later recurrence (first (<i>p </i>< 0.001), and second recurrent diagnosis (<i>p </i>= 0.143)) significantly influences patient OS. Increased HE4 concentration at the end of chemotherapeutic treatment negatively affects overall patient survival ((<i>p </i>= 0.006 for second line chemotherapy and (<i>p </i>= 0.022) for elevated HE4 concentration after the last course of third-line chemotherapy). Our preliminary results show an encouraging diagnostic and prognostic role of HE4 in recurrent ovarian cancer. HE4 measurements at different treatment time points during the second- and third-line chemotherapy treatment seem to correlate with patient survival. |
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| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-11T09:49:03Z |
| publishDate | 2023-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-59df127cc98c41ce8a7168b1c3d3cb2e2023-11-16T16:24:54ZengMDPI AGDiagnostics2075-44182023-01-0113345210.3390/diagnostics13030452Evaluation of He4 Use in the Diagnosis of Ovarian Cancer: First and Second Recurrence, and an Analysis of HE4 Concentration during Second- and Third-Line ChemotherapyAnita Chudecka-Głaz0Aleksandra Strojna1Kaja Michalczyk2Sylwia Wieder-Huszla3Krzysztof Safranow4Edyta Skwirczyńska5Anna Jurczak6Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, 70-204 Szczecin, PolandDepartment of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, 70-204 Szczecin, PolandDepartment of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, 70-204 Szczecin, PolandDepartment of Clinical Nursing, Pomeranian Medical University, 71-210 Szczecin, PolandDepartment of Biochemistry and Medical Chemistry, Pomeranian Medical University, 70-111 Szczecin, PolandDepartment of History of Medicine and Medical Ethics, Pomeranian Medical University in Szczecin, 70-204 Szczecin, PolandDepartment of Clinical Nursing, Pomeranian Medical University, 71-210 Szczecin, PolandHE4 is a commonly used tumor marker for ovarian cancer (OC) diagnosis. In our study, we aimed to assess its use in the diagnosis of subsequent OC recurrences and to evaluate its changes during recurrence diagnosis and the subsequent lines of chemotherapy treatment. This retrospective single center study was conducted on 188 patients treated for ovarian cancer recurrence at the Department of Gynecological Surgery and Gynecological Oncology. The sensitivity and specificity of HE4 for patient survival prediction were analyzed using Receiver Operating Characteristics (ROC) and area under the curve (AUC) with 95% confidence intervals (95% CI). Survival times to reach one of the endpoints (OS, PFS, TFI, PFS2, TFI2) were analyzed using Kaplan–Meier curves. Elevated HE4 levels at the time of first relapse diagnosis, and after the third and the last course of second-line chemotherapy, significantly influences the time from OC diagnosis until first disease recurrence (PFS2) (<i>p </i>= 0.005, <i>p </i>= 0.015 and <i>p </i>= 0.002, respectively). Additionally, elevated serum HE4 concentration at the time of OC diagnosis (<i>p </i>= 0.012), and its later recurrence (first (<i>p </i>< 0.001), and second recurrent diagnosis (<i>p </i>= 0.143)) significantly influences patient OS. Increased HE4 concentration at the end of chemotherapeutic treatment negatively affects overall patient survival ((<i>p </i>= 0.006 for second line chemotherapy and (<i>p </i>= 0.022) for elevated HE4 concentration after the last course of third-line chemotherapy). Our preliminary results show an encouraging diagnostic and prognostic role of HE4 in recurrent ovarian cancer. HE4 measurements at different treatment time points during the second- and third-line chemotherapy treatment seem to correlate with patient survival.https://www.mdpi.com/2075-4418/13/3/452ovarian cancerdiagnosismonitoringchemotherapyHE4 |
| spellingShingle | Anita Chudecka-Głaz Aleksandra Strojna Kaja Michalczyk Sylwia Wieder-Huszla Krzysztof Safranow Edyta Skwirczyńska Anna Jurczak Evaluation of He4 Use in the Diagnosis of Ovarian Cancer: First and Second Recurrence, and an Analysis of HE4 Concentration during Second- and Third-Line Chemotherapy Diagnostics ovarian cancer diagnosis monitoring chemotherapy HE4 |
| title | Evaluation of He4 Use in the Diagnosis of Ovarian Cancer: First and Second Recurrence, and an Analysis of HE4 Concentration during Second- and Third-Line Chemotherapy |
| title_full | Evaluation of He4 Use in the Diagnosis of Ovarian Cancer: First and Second Recurrence, and an Analysis of HE4 Concentration during Second- and Third-Line Chemotherapy |
| title_fullStr | Evaluation of He4 Use in the Diagnosis of Ovarian Cancer: First and Second Recurrence, and an Analysis of HE4 Concentration during Second- and Third-Line Chemotherapy |
| title_full_unstemmed | Evaluation of He4 Use in the Diagnosis of Ovarian Cancer: First and Second Recurrence, and an Analysis of HE4 Concentration during Second- and Third-Line Chemotherapy |
| title_short | Evaluation of He4 Use in the Diagnosis of Ovarian Cancer: First and Second Recurrence, and an Analysis of HE4 Concentration during Second- and Third-Line Chemotherapy |
| title_sort | evaluation of he4 use in the diagnosis of ovarian cancer first and second recurrence and an analysis of he4 concentration during second and third line chemotherapy |
| topic | ovarian cancer diagnosis monitoring chemotherapy HE4 |
| url | https://www.mdpi.com/2075-4418/13/3/452 |
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