J Gynecol Oncol.  2017 Mar;28(2):e11. 10.3802/jgo.2017.28.e11.

Preoperative CA125 and fibrinogen in patients with endometrial cancer: a risk model for predicting lymphovascular space invasion

• Zhou X
• Wang H
• Wang X

• KMID: 2413454
• DOI: http://doi.org/10.3802/jgo.2017.28.e11

Abstract

OBJECTIVE
The aim of this study was to build a model to predict the risk of lymphovascular space invasion (LVSI) in women with endometrial cancer (EC).
METHODS
From December 2010 to June 2013, 211 patients with EC undergoing surgery at Shanghai First Maternity and Infant Hospital were enrolled in this retrospective study. Those patients were divided into a positive LVSI group and a negative LVSI group. The clinical and pathological characteristics were compared between the two groups; logistic regression was used to explore risk factors associated with LVSI occurrence. The threshold values of significant factors were calculated to build a risk model and predict LVSI.
RESULTS
There were 190 patients who were negative for LVSI and 21 patients were positive for LVSI out of 211 patients with EC. It was found that tumor grade, depth of myometrial invasion, number of pelvic lymph nodes, and International Federation of Gynecology and Obstetrics (FIGO) stage (p<0.05) were associated with LVSI occurrence. However, cervical involvement and age (p>0.05) were not associated with LVSI. Receiver operating characteristic (ROC) curves revealed that the threshold values of the following factors were correlated with positive LVSI: 28.1 U/mL of CA19-9, 21.2 U/mL of CA125, 2.58 mg/dL of fibrinogen (Fn), 1.84 U/mL of carcinoembryonic antigen (CEA) and (6.35×10⁹)/L of white blood cell (WBC). Logistic regression analysis indicated that CA125 ≥21.2 (p=0.032) and Fn ≥2.58 mg/dL (p=0.014) were significantly associated with LVSI.
CONCLUSION
Positive LVSI could be predicted by CA125 ≥21.2 U/mL and Fn ≥2.58 mg/dL in women with EC. It could help gynecologists better adapt surgical staging and adjuvant therapies.

Keyword

Endometrial Neoplasms; Lymphovascular Space Invasion; CA-125 Antigen; Fibrinogen

MeSH Terms

Adenocarcinoma/*pathology/secondary/surgery
CA-125 Antigen/*analysis
Case-Control Studies
Endometrial Neoplasms/*pathology/surgery
Female
Fibrinogen/*analysis
Humans
Logistic Models
Lymphatic Metastasis/diagnosis/*pathology
Middle Aged
ROC Curve
Retrospective Studies
Risk
Sensitivity and Specificity
CA-125 Antigen
Fibrinogen