Utility of pre-operative magnetic resonance imaging (pelvis and abdomen) and combined tumour markers HE4 and CA125 in diagnosing early and advanced carcinoma endometrium.

BACKGROUND

Endometrial cancer is the most common gynaecological cancer and is known to be the fourth commonest cancer overall and the seventh leading cause of cancer-causing death. Measurement of serum CA125 is commonly used in evaluation and follow up process of patients with ovarian cancer. HE4- a novel tumour marker is over-expressed in patients with serous and endometroid epithelial ovarian carcinomas and uterine cancers. The aim of this study was to assess utility of pre-operative magnetic resonance imaging (MRI) (pelvis and abdomen) and combined Tumour Markers HE4 & CA125 in diagnosing Early and Advanced stage disease in endometrial cancer.

METHODS

The present cross sectional pilot study was carried out at the outpatient department of Obst & Gynae in a tertiary care hospital. During the study period from March 2021 to Feb 2023, patients with diagnosis of carcinoma endometrium were included. A total 25 cases were included. CA 125 and HE 4 tumor markers were done for each patient Depth of myometrial invasion, histological grade, cervical stromal involvement and presence or absence of nodal metastasis was recorded and pre-op stage assessed.

RESULTS

More than 50% of endometrial cancers are diagnosed in women older than 55. Type I (grade 1 or 2 endometrioid) endometrial cancer is commoner 80% and type II (grade 3 endometrioid, serous, clear cell, and carcinosarcoma) in remaining 20% cases. Sensitivity and specificity of CA 125 was 100% each. Sensitivity and specificity of HE 4 was 75% and 60% each.

CONCLUSION

Higher levels of HE4 and CA125 were observed in patients with deep myometrial invasion and higher grade of tumor.