HE4 與子宮內膜癌的檢視

HE4 and Endometrial Cancer

子宮內膜癌的標準手術方法是全子宮切除、兩側輸卵管卵巢切除、骨盆腔和主動脈旁淋巴結摘除。但在細胞分化良好或中度者，或第Ⅰ期a的子宮內膜癌，則不一定需要摘除淋巴結，主要因為淋巴結摘除會有出血、淋巴囊腫、淋巴水腫等風險，因此術前診斷出早期子宮內膜癌甚為重要。最近的研究顯示，HE4或許有助於預測子宮內膜癌不良預後因子，如肌肉侵犯深度、細胞分化、子宮頸侵犯、病灶轉移之可能，對日後治療應有幫助。

The role of the preoperative accurate diagnosis of early stage of endometrial cancer is essential, because there are still many controversies regarding the role of lymphadenectomy. A lymphadenectomy increases both the time of the operation and blood loss and may cause a lower extremity lymphedema with an adverse effect on the patients quality of life. Some patients with stage I disease will carry intermediate to high risk factors such as depth of invasion and lymphovascular involvement. Recently, HE4 might provide preoperative prognostic value to help guide the extent of surgical staging, thus contributing to the goal of improving overall patient care. In addition, HE4 is considerable advantage over CA125 in identifying stage I endometrioid adenocarcinomas indicated its potential prognostic value in the earlier detection of endometrial cancer recurrence.