International Journal of Hematology and Oncology 2022, Vol 32, Num 2 Page(s): 126-132
Prognostic Significance of Serum Human Epididymis Protein 4 Level in Patients with Locally Advanced Non-Small Cell Lung Cancer who Underwent Definitive Chemo-Radiotherapy

Guler YAVAS1, Sumerya Duru BIRGI2, Ali UNLU3, Cagdas YAVAS1, Mursel DUZOVA4, Serap AKYUREK2

1Baskent University Faculty of Medicine, Department of Radiation Oncology, Ankara, Konya TURKEY
2Ankara University Faculty of Medicine, Department of Radiation Oncology, Ankara, Konya TURKEY
3Selcuk University Faculty of Medicine, Department of Biochemistry, Konya, Konya TURKEY
4Selcuk University Faculty of Medicine, Department of Radiation Oncology, Konya TURKEY

Keywords: Non-small cell lung cancer, Locally advanced, oncurrent chemo-radiotherapy, Human epididymis protein 4
We aimed to investigate the prognostic significance of serum human epididymis protein 4 (HE4) level in patients with locally advanced non-small cell lung cancer (LA-NSCLC) who underwent definitive chemo-radiotherapy (CRT). A hundred seventeen patients with the diagnosis of LA- NSCLC were enrolled. The serum concentrations of HE4 were measured at the beginning of CRT, at the end of CRT, and 3 months after the completion of CRT. The median follow-up period was 21.7 months (range, 5.4-39.8 months). The mean serum HE4 levels prior to CRT, at the end of the CRT, and 3rd month after the completion of CRT were 159.2, 130.2, and 127.5, respectively (p= 0.023). The median progression free survival (PFS) was 15.4 months. One, and two-year PFS rates were 58.1%, and 22.2%, respectively. One, and two- year expected survival rates were 81.2%, and 62%, respectively. In multivariate analysis, stage (p= 0.002), HE4 levels after 3 months of CRT (p= 0.037) were predictive of OS. Stage IIIC patients had 10.2 times likely to death when compared to stage IIIA patients (95%CI: 2.3-45.7; p= 0.037). The increase of 1 HE4 levels after 3 months of CRT increased the mortality rate 1.002 (95%CI: 1.000-1.0004; p= 0.037). In multivariate analysis stage was predictive of PFS. When compared to stage IIIA patients, stage IIIC patients have 2.5 times risk for progression (95% CI: 1.2-5.2; p= 0.014). Our findings suggested that serum HE4 may be an important prognostic biomarker for LA-NSCLC patients. This issue warrants further prospective studies with more patient populations.