utility of pelvic mri and tumor markers he4 and ca125 to predict depth of myometrial invasion and cervical involvement in endometrial cancer

objective: the purpose of this pilot study was to determine whether the mri and biomarkers human epididymis protein 4 (he 4 ) and ca 125 correlate with depth of myometrial invasion, histologic grade, cervical involvement and nodal metastases in patients with endometrioid adenocarcinoma of the uterus. materials and methods: this was a prospective, observational study in women with biopsy-proven endometrial adenocarcinoma of the uterus. preoperative pelvic mri was performed and concentration of he 4 and ca 125 were assessed before surgery. all surgical specimens were reviewed by a single expert pathologist. the results were compared with the final histopathology report of surgical staging. results: included were a total of 68 women with endometrioid adenocarcinoma of the uterus, most (76%) with stage i disease. levels of serum he 4 greater than 140pm and ca 125 greater than 35 ku/l were observed in 12 (17%) and 26 (38.2%) of patients respectively whose greater proportion were cases with deep myometrial invasion and high grade tumor. in the evaluation of deep tumoral invasion (> 50%) of the myometrium sensitivity, specificity, and diagnostic accuracy of mri were 68.9%, 94.8% and 83.8% respectively. for lymph node involvement these values were 50%, 95.1% and 91.1% respectively and for cervical stromal involvement were 64.3%, 98.1% and 91.1% respectively. conclusion: higher stage, deep myometrial invasion, and lymph node or cervical stromal involvement increase diagnostic accuracy of mri. higher levels of he 4 and ca 125 were observed in patients with deep myometrial invasion and higher grade of tumor.