Tumor Biology

, Volume 37, Issue 4, pp 4973–4978 | Cite as

The role of HE4 in endometrial cancer recurrence: how to choose the optimal follow-up program

  • Roberto Angioli
  • Stella Capriglione
  • Giuseppe Scaletta
  • Alessia Aloisi
  • Andrea Miranda
  • Carlo De Cicco Nardone
  • Corrado Terranova
  • Francesco Plotti
Original Article


The aim of this study was to evaluate for the first time in the literature the role of HE4, at primary diagnosis, compared to CA125 as an indicator of endometrial cancer (EC) recurrence. Our study is a retrospective analysis of 252 EC patients treated, between January 2009 and July 2013, at the Division of Gynaecologic Oncology of Campus Bio-Medico University of Rome. Thirty-seven patients experienced recurrence. Median follow-up was 38 months. HE4 and CA125 levels were analyzed at primary diagnosis, during follow-up and either after histological or radiological confirmation of recurrent disease or at last registered visit, when patients returned to our Department with no evidence of recurrent disease. A statistically significant difference was observed between HE4 values at primary diagnosis and at recurrence, respectively, comparing recurrent and non-recurrent patients (p < 0.05), while CA125 values resulted not statistically significant (p = 0.08) at each time point. Considering the poor specificity of HE4 at threshold of 70 pmol/L at primary diagnosis, in our cohort of patients, we found out that HE4 cut-off of 201.3 pmol/L is able to correctly classify patients at high or low risk of EC recurrence, with a sensitivity of 80 % and a specificity of 91 % (PPV = 90.3 % and NPV = 90.8 %). In particular, HE4 performance improves in cases of endometrioid histotype. HE4 levels at primary diagnosis correlate with an increased risk of EC recurrence, particularly in cases of endometrioid histotype, and they may help to recognize patients who may need a more intensive follow-up.


Endometrial cancer HE4 Prognostic factor Recurrence 


Compliance with ethical standards

Conflicts of interest



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Copyright information

© International Society of Oncology and BioMarkers (ISOBM) 2015

Authors and Affiliations

  • Roberto Angioli
    • 1
  • Stella Capriglione
    • 1
  • Giuseppe Scaletta
    • 1
  • Alessia Aloisi
    • 1
  • Andrea Miranda
    • 1
  • Carlo De Cicco Nardone
    • 1
  • Corrado Terranova
    • 1
  • Francesco Plotti
    • 1
  1. 1.Department of ObstetricsUniversity of Rome “Campus Bio-Medico”RomeItaly

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