Estrogen/Progesterone Receptor Expression and Cancer Antigen 125 Level as Preoperative Predictors to Estimate Lymph Node Metastasis in Endometrioid Endometrial Cancer

被引:2
作者
Wang, Shao-Chi [1 ,2 ]
Wu, Chen-Hsuan
Fu, Hung-Chun [1 ,2 ]
Ou, Yu-Che [3 ,4 ]
Tsai, Ching-Chou [1 ,2 ]
Chen, Ying-Yi
Wang, Ying-Wen [1 ,2 ]
Hunag, Szu-Wei
Huang, Szu-Yu
Lan, Jui
Lin, Hao [1 ,2 ,5 ]
机构
[1] Chang Gung Univ, Coll Med, Dept Obstet, Kaohsiung, Taiwan
[2] Chang Gung Univ, Coll Med, Dept Gynecol, Kaohsiung, Taiwan
[3] Chang Gung Univ, Kaohsiung Chang Gung Mem Hosp, Anat Pathol, Coll Med, Kaohsiung, Taiwan
[4] Chia Yi Chang Gung Mem Hosp, Dept Obstet & Gynecol, Chiayi, Taiwan
[5] Kaohsiung Chang Gung Mem Hosp, Dept Obstet & Gynecol, 123 Dapi Rd, Kaohsiung 833, Taiwan
关键词
CA; 125; endometrial cancer; estrogen/progesterone receptor; immunohistochemical staining; lymph node metastasis; LOW-RISK GROUP; PROGESTERONE-RECEPTOR; PELVIC LYMPHADENECTOMY; CARCINOMA; ESTROGEN; COMPLICATIONS; ACCURACY; EFFICACY;
D O I
10.1097/PGP.0000000000000984
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Loss of estrogen receptor/progesterone receptor (ER/PR) in endometrial cancer (EC) is associated with tumor progression and poor outcomes. Elevated pretreatment cancer antigen 125 (CA 125) level is a risk factor for lymph node metastasis (LNM). We evaluated whether the combination of ER/PR expression and CA 125 level could be used as a biomarker to predict LNM. We retrospectively investigated patients with endometrioid EC who underwent complete staging surgery during January 2015 to December 2020. We analyzed ER/PR status using immunohistochemical staining, and quantified its expression using the sum of both ER/PR H-scores. Receiver operating characteristic curves were used to identify optimal cutoff values of H-score and CA 125 levels for predicting LNM. A nomogram for predicting LNM was constructed and validated by bootstrap resampling. In 396 patients, the optimal cutoff values of the ER/PR H-score and CA 125 were 407 (area under the receiver operating characteristic curve: 0.645, P=0.001) and 40 U/mL (area under the receiver operating characteristic curve: 0.762, P<0.001), respectively. Multivariate analysis showed that CA 125 >= 40 UmL (odds ratio: 10.02; 95% CI: 4.74-21.18) and ER/PR H-score <407 (odds ratio: 4.20; 95% CI: 1.55-11.32) were independent predictors. An LNM predictive nomogram was constructed using these 2 variables and our model yielded a negative predictive value and negative likelihood ratio of 98.3% and 0.14, respectively. ER/PR expression with pretreatment CA 125 levels can help estimate LNM risk and aid in decision-making regarding the need for lymphadenectomy in patients with endometrioid EC.
引用
收藏
页码:316 / 325
页数:10
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