Comparison of Diagnostic Accuracies of Serum HE-4 Levels and 3D Power Doppler Angiography Parameters between Benign Endometrial Pathologies and Endometrial Cancer

  • Erenel, Hakan (Department of Obstetrics and Gynecology, Sisli Hamidiye Etfal Training and Research Hospital) ;
  • Bese, Tugan (Department of Obstetrics and Gynecology, Sisli Hamidiye Etfal Training and Research Hospital) ;
  • Sal, Veysel (Department of Obstetrics and Gynecology, Sisli Hamidiye Etfal Training and Research Hospital) ;
  • Demirkiran, Fuat (Department of Obstetrics and Gynecology, Sisli Hamidiye Etfal Training and Research Hospital) ;
  • Arvas, Macit (Department of Obstetrics and Gynecology, Sisli Hamidiye Etfal Training and Research Hospital)
  • Published : 2016.05.01


Purpose: To study the diagnostic accuracies of serum human epididymis protein 4 (HE-4) levels, virtual organ computer-aided analysis (VOCAL) parameters and endometrial volume in endometrial cancer cases. Materials and Methods: One hundred and seven patients (37 with endometrial cancer and 70 with benign endometrial pathology) were included in this study. VOCAL parameters and serum HE-4 levels were compared between the groups. Results: Area under the curve (AUC) values were 0.702, 0.658, 0.706 for vascularization index (VI), the flow index (FI) and the vascularization flow index (VFI), respectively. A cut off value of 0.568 for VI demonstrated 70% sensitivity, 72% specificity, 56% positive predictive value (PPV) and a81% negative predictive value (NPV). A cut off value of 25.8 for showed a senitivith of 70% and a specificity of 58% with aPPV of 46% and NPV of 78%, and with a cut off value of 0.12 for VFI 70%, 69%, 54% and 81%, respectively. The area under the curve for HE-4 was 0.814. A cut off value of 458 pmol/L was predictive of malignancy with 86% sensitivity and 63% specificity. Conclusions: VOCAL parameters and serum HE-4 levels were statistically significantly higher in the endometrial cancer patients. Serum HE-4 levels provided a greater sensitivity compared to power doppler angiography for predicting malignancy or benign endometrial pathology.


Endometrial cancer;colour doppler;HE-4 protein;three-dimensional;ultrasonography


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