Study on the Correlation between Tumor Load and Tumor Markers HE4 and CA125 in Advanced Epithelial Ovarian Cancer Assessed by PET-CT
Objective This study was conducted to investigate the correlation between serum HE4 and CA125 concentrations and 2-[18F]FDG PET/CT parameters in evaluating tumor burden in patients with advanced high-grade epithelial ovarian cancer.Methods 66 patients who received 2-[18F]FDG PET/CT and serum tumor markers before initial treatment were assigned the volume of interest at each pathological uptake.Total metabolic tumor volume(wb_MTV)and total pathological glycolysis(wb_TLG)were calculated,and MTV values of each VOI were obtained.The SUVmax threshold is set to 40%(MTV40 and TLG40)and 50%(MTV50 and TLG50).In addition,four VOI subtypes were defined:peritoneal carcinomatosis,retroperitoneal nodules,supradiaphragmatic nodules,and distant metastases.The MTV and TLG for each group are calculated by adding the corresponding MTV values.TLG did the same calculation.Results wb_MTV and wb_TLG were significantly correlated with serum CA125 and HE4 concentrations.The correlation between HE4 and WB_MTV40 was strongest(r=0.62,P<0.001).The Pearson correlation coefficients between MTV40 and tumor markers for HE4 and CA125 peritoneal cancer were 0.61(P<0.0001)and 0.29(P=0.02),respectively.None of these tumor markers showed a positive correlation with the extraperitoneal tumor burden as assessed by volume parameters.Conclusion HE4 is a better predictor of metabolic tumor load in patients with high-grade epithelial ovarian cancer before initial treatment than CA125.2-[18F]FDG PET/CT volume parameters are a viable tool for objective assessment of tumor load and its anatomic distribution,and these results suooort the effectiveness of HE4 and PET/CT in imoroving patient stratification in clinical practice.
Ovarian Epithelial CarcinomaPositron Emission TomographyTumor BiomarkersCA-125 AntigenHuman Epididymal Protein 4