Prognostic Significance of preoperative serum CA125, CA19-9, CA72-4,
CEA, and AFP in Patients with Endometrial carcinoma
Abstract
Background: To determine the factors related to overall survival (OS)
and progression-free survival (PFS) in endometrial carcinoma (EC)
patients. Methods: A retrospective cohort study of 906 EC patients was
conducted at Shengjing Hospital, China Medical University. Baseline
information about the patients, tumor characteristics, and data on five
serum biomarkers (CA125, CA19-9, CA72-4, CEA, and AFP) were collected.
Groups and their survival rates were compared using log-rank tests and
Kaplan-Meier analysis, respectively. Hazard ratios (HRs) and 95%
confidence intervals (CIs) were determined using univariate or
multivariate Cox proportional hazard models. The outcome measures used
were OS, defined as the time between surgery and death or last follow-up
for surviving patients, and PFS, defined as the time from the completion
of initial surgery to either first progression, disease recurrence, or
death. Results: Multivariate analysis showed lower PFS associated with
age ≥ 66 years (P < 0.001), non-endometrioid histology (P =
0.015), low degree of tumor differentiation (P = 0.004), and FIGO stage
III & IV (P = 0.002). Elevated CA125 (P = 0.042) and AFP (P = 0.016)
were identified as independent biomarkers for PFS. Increased CA125 (P =
0.013), age ≥ 66 years (P < 0.001), non-endometrioid histology
(P<0.001), and FIGO stage III & IV (P = 0.015) were independent
factors associated with OS. Analysis of the CA125 sub-group showed that
individuals with elevated CA125 andAFP (P = 0.049) had significantly
lower PFS. Conclusion: This study suggests that CA125 and AFP are
prognostic biomarkers for EC