Rendimiento del HE4 en el diagnóstico, pronóstico y predicción de recidiva en cáncer de endometrio.
HE4 performance in the diagnosis, prognosis and prediction of relapse in endometrial cancer.
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Introducción: el cáncer de endometrio es un cáncer ginecológico frecuente. La biopsia de endometrio es la prueba de oro para el diagnóstico. Ningún biomarcador ha mostrado relevancia clínica hasta el momento. El HE4 parece ser de alta sensibilidad y especificidad, incluso en los estadios tempranos. Objetivos: analizar la evidencia médica publicada hasta la fecha sobre el potencial valor del HE4 como prueba diagnóstica, al igual que su utilidad en lo concerniente al pronóstico y recaída en las pacientes con cáncer de endometrio. Materiales y métodos: se realizó revisión narrativa de la literatura en las bases de datos Pubmed-Medline y EMBASE desde 1990 a 2016. La búsqueda se estructuró utilizando términos MESH. Resultados: los resultados de sensibilidad varían según los diferentes puntos de cortes de HE4 entre 41% y 94%, especificidad entre 36% y 100%. El punto de corte que mejor rendimiento mostró fue 70 pmol/L, con sensibilidad de 59.4% y especificidad de 100%. En pronóstico, los estudios muestran que el HE4 puede ayudar en la predicción del riesgo de invasión miometrial, para la adecuada estatificación, así como definición del compromiso extrauterino y ganglionar para determinar de una manera más acertada la necesidad de linfadenectomía. Conclusión: resultados iniciales sugieren que el HE4 es un biomarcador que puede ser útil en el diagnóstico de las mujeres con cáncer de endometrio, además puede identificar aquellas con alto riesgo de recurrencia y puede ser utilizado en el seguimiento y detección de esta.
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