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| 1 | Preoperative markers for the prediction of high-risk features in endometrial cancer显示文摘BACKGROUND Preoperative evaluations aiming to assess high-risk features in clinical stage 1 endometrial cancer patients are crucial to refer these patients to gynecologic oncologists.Cancer antigen 125(CA125)and human epididymis protein 4(HE4)have been reported in endometrial cancer patients with poor prognostic factors.AIM To evaluate the association between preoperative levels of CA125 and HE4 and high-risk features and establish optimal cut-off values in clinical stage 1 endometrial cancer.METHODS A retrospective study was conducted in clinical stage 1 endometrial cancer patients who underwent primary surgery between January 2013 and December 2018.A total of 128 patients had preoperative serum CA125 and HE4 measurements.High-risk features included grade 3 tumors,large tumor sizes(more than 2 cm),deep myometrial invasion(more than 50%),lymphovascular space invasion(LVSI),cervical involvement,extrauterine involvement and node metastasis.Receiver operating characteristic(ROC)curves were generated to analyze the optimal cut-off values.RESULTS The mean age of the patients was 57.4 years,and 69.5%of them were postmenopausal.Most patients presented with stage I disease(67.2%)and had the endometrioid subtype(97.7%).The median CA125 and HE4 levels in all patients were 22.1 U/mL and 104.7 pmol/L,respectively.CA125 and HE4 levels were significantly elevated in those with large tumor sizes,deep myometrial invasion,LVSI,extrauterine metastasis,and advanced stage,but node metastasis was associated with elevated CA125 only.According to the ROC curve,both serum markers had statistical significance for the prediction of high-risk features only in postmenopausal patients,with an optimal cut-off value of 20 U/mL for CA125[area under the concentration-time curve(AUC)=0.72,P=0.002]and 113 pmol/L for HE4(AUC=0.70,P=0.006).The combination of both serum markers had 80%sensitivity and 64.4%positive predictive value.Significantly worse 5-year disease-free survival was observed in patients with high levels of CA125 and HE4(78.4%and 100%,respectively;P=0.01).CONCLUSION Preoperative CA125 levels greater than 20 U/mL or HE4 levels greater than 113 pmol/L are associated with an increased risk of having high-risk features and present as prognostic factors in clinical stage 1 postmenopausal endometrial cancer patients.This information is helpful for general gynecologists to refer high-risk patients to gynecologic oncologists to perform complete surgical staging. | Pinyada Panyavaranant Tarinee Manchana | 2020 | World Journal of Clinical Oncology2020，11，6： | 4 |
| 2 | Longterm lower urinary tract dysfunction after radical hysterectomy in patients with early postoperative voiding dysfunction显示文摘 | Manchana T Prasartsakulchai C Santingamkun A | | 0，，： | 1 |
| 3 | Lack of prognostic significance of her-2/neu in early epithelial ovarian cancer显示文摘 | Sueblinvong T Manchana T Khemapech N | 2007 | Asian Pac J Cancer Prev2007，8，4： | 1 |
| 4 | Long term complications after radical hysterectomy with pelvic lymphadenectomy显示文摘 | Manchana T Sirisabya N Lertkhachonsuk R | 2009 | J Med Assoc Thai2009，92，4： | 1 |
| 5 | Prevalence and prognostic significance of COX-2 expression in stage Ⅰ B cervical cancer显示文摘 | Manchana T Triratnachat S Sirisabya N | 2006 | Gynecol Oncol2006，100，3： | 1 |
| 6 | Prevalence and prognostic significance of COX-2 expression in stage IB cervical cancer显示文摘 | Manchana T Triratanachat S Sirisabya N | 2006 | Gynecol oncol2006，100，3： | 1 |
| 7 | Long term complications after radical hysterectomy with pelvic lymphadenectomy 显示文摘 | Manchana T | 2009 | J Med Assoc Thai2009，92，4： | 1 |
| 8 | Efficacy of acupuncture in prevention of delayed chemotherapy induced nausea and vomiting in gynecologic cancer patients显示文摘 | RITHIRANGSRIROJ K MANCHANA T AKKAYAGORN L | 2015 | Gynecol Oncol2015，136，1： | 1 |
| 9 | Long- term urinary lower tract dysfunction after radical hysterec- tomy in patients with early postoperative voiding dysfunc- tion显示文摘 | Manchana T Prasartsakulchai C Santingamkun A | 2010 | Int Urogynecol J2010，21，1： | 1 |
| 10 | Prevalence and Prog- nostic significance of COX-2 expression in stage I B cervical cancer 显示文摘 | Manchana T Triratnachat S Sirisabya N | 2006 | Gynecol Onco12006，100，3： | 1 |
| 11 | Long-term lower urinary tract dysfunction in gynecologic cancer survivors 显示文摘 | MANCHANA T | 2011 | Asian Pac J Cancer Prey2011，12，1： | 1 |
| 12 | Prevalence and prognostic significance of Cox-2 expression in stage IB cervical cance显示文摘 | Manchana T Triratanachat S Sirisabya N | 2006 | Gynecol Oncol2006，100，3： | 1 |
| 13 | Long term complications after radical hysterectomy with pelvic lymphadenectomy显示文摘 | Manchana T Sirisabya N Lertkhachonsuk R | 2009 | J Med Assoc Thai2009，92，4： | 1 |
| 14 | Lower urinary tract dysfunction and quality of life in cervical cancer survivors after concurrent chemoradiation versus radical hysterectomy显示文摘 | Chanita Katepratoom Tarinee Manchana Napapat Amornwichet | 2014 | International Urogynecology Journal2014，，1： | 1 |
| 15 | Prevalence and prognostic significance of COX-2 expression in stage IB cervical cancer显示文摘 | Manchana T Triratanachat S Sirisabya N | 2006 | Gynecol Oncol2006，100，3： | 1 |
| 16 | Long term compucayions after radical hysterectomy with pelvic lymphadenectomy显示文摘 | Manchana T Sirisabya N Lertkhachonsuk R | 2009 | J Med Assoc Thai2009，92，4： | 1 |
| 17 | Prevalence and prognostic significance of COX-2 expression in stage IB cervical cancer显示文摘 | Manchana T Triratanachat S Sirisabya N | 2006 | Gynecol Oncol2006，100，3： | 1 |
| 18 | Blood transfusion reduction with intravenous iron in gynecologic cancer patients receiving chemotherapy显示文摘 | Dangsuwan P Manchana T | 2010 | Gynecol Oncol2010，116，3： | 1 |
| 19 | Efficacy of acupuncture in prevention of delayed chemotherapy induced nausea and vomiting in gynecologic cancer patients显示文摘 | Rithirangsriroj K Manchana T Akkayagorn L | 2015 | Gynecol Onco12015，136，1： | 1 |
| 20 | Transient cortical blindness during chemotherapy (PVB) for ovarian germ cell tumor显示文摘 | Manchana T Sirisabya N Lertkhachonsuk R | 2006 | J Med Assoc Thai2006，89，8： | 1 |
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