The predictive effect of serum carbohydrate antigen125 combined with human epididymis protein 4 detection on postoperative recurrence in patients with endometriosis
TANG Qinghua
LÜ Jie
SUN Peiyan
LI Zhuyin
HAO Luyao
Abstract：Objective To investigate the predictive effect of serum carbohydrate antigen 125(CA125)and human epididymis protein 4(HE4)on postoperative recurrence in patients with endometriosis(EMs).Methods A total of 95 EMs patients admitted to the Third Affiliated Hospital of Zhengzhou University from April 2020 to July 2023 were selected as the study subjects.According to the staging criteria of American Society for Reproductive Medicine(ASRM),95 EMs patients were divided into s tage Ⅰ-Ⅱ(n=35)and stage Ⅲ-Ⅳ(n=60).The levels of serum CA125 and HE4 in EMs patients with different ASRM stages were detected and compared.After one year of follow-up,the recurrence situation was statistically analyzed,and the general data and laboratory examination indexes(age,disease classification,parity,history of uterine cavity operation,postoperative dysmenorrhea,ASRM stage,preoperative serum CA125 level and preoperative serum HE4 level)were compared between the recurrence group and the non-recurrence group.Multivariate logistic regression was used to analyze the risk factors affecting postoperative recurrence of EMs.The receiver operating characteristic(ROC)curve was used to evaluate the value of serum CA125 and HE4 alone and in combination in predicting postoperative recurrence in EMs patients.Results The levels of serum CA125 and HE4 in patients with ASRM stage Ⅲ-Ⅳ were significantly higher than those in patients with ASRM stageⅠ-Ⅱ[CA125:(45.21±5.09)U/mL vs.(27.49±4.21)U/mL].HE4:(168.14±14.47)pmol/L vs.(143.25±12.25)pmol/L;t=17.403,8.541,P<0.001].There were 13 cases of recurrence one year after surgery and 82 cases without recurrence.The percentage of patients with postoperative dysmenorrhoea in the recurrence group(46.15％,6/13),the percentage of ASRM stage Ⅲ-Ⅳ(76.92％,10/13),and the preoperative serum CA125[(49.46±5.56)U/mL]and HE4 levels[(63.26±4.32)pmol/L]were higher than those in the non recurrence group[19.51％(16/82),30.49％(25/82),(36.96±4.23)U/mL,(50.97±2.27)pmol/L;χ2=4.475,10.398,t=9.464,15.677,P<0.05].There was no statistically significant difference between the two groups when comparing the age of the patients,disease staging,number of deliveries,and history of uterine surgery(P>0.05).Multivariate logistic analysis showed that postoperative dysmenorrhoea,ASRM stage Ⅲ-Ⅳ,and rising serum CA125 and HE4 levels were risk factors for postoperative recurrence of EMs(OR=6.215,5.786,5.295,4.869,P<0.05).As shown by the ROC curve,the sensitivity and specificity of the combined prediction of CA125 and HE4 for the postoperative recurrence risk of EMs patients were 89.47％and 89.12％,respectively,and the area under the curve(AUC)was 0.924,which were higher than that predicted by CA125 and HE4 alone(CA125:75.93％,81.49％,0.798,respectively;HE4:72.52％,79.86％,0.822).Conclusions The levels of CA125 and HE4 are highly expressed in patients with EMs stage Ⅲ-Ⅳ,and the combined monitoring of the changes of the above indicators can effectively evaluate the recurrence risk after EMs surgery,and provide a scientific basis for formulating individualized treatment plans.
Keywords：carbohydrate antigen 125human epididymis protein 4endometriosisrecurrencerisk factors
Publication Date：2025-10-28
Online Publishing Date：2025-11-24(First online date of this platform, not the publication date of the document)
Pages：5( 364-368 )