Epidemiologic and biologic correlates of serum HE4 and CA125 in women from the National Health and Nutritional Survey (NHANES)

Analysis of risk factors for sentinel lymph node metastasis in patients with endometrial cancer

OBJECTIVE

To investigate the risk factors of sentinel lymph node (SLN) metastasis in patients with endometrial carcinoma (EC), and to establish a risk nomogram model.

METHODS

In this retrospective study, the clinical data of 79 EC patients who were treated in Zhumadian Central Hospital from January 2019 to January 2021 were analyzed. The patients were divided into SLN positive group and SLN negative group according to the occurrence of SLN metastasis. Univariate and multivariate analyses were performed to explore the factors affecting the occurrence of SLN metastasis in EC patients. The nomogram model predicting the risk of SLN metastasis in EC patients was constructed. The discrimination, accuracy and clinical benefit rate of the model were evaluated.

RESULTS

Multivariate analysis showed that body mass index (BMI) ≥ 24 kg/m², tumor diameter ≥ 2 cm, low differentiation, and cervical stromal involvement were risk factors for SLN metastasis in EC patients (P < 0.05). And the risk of SLN in EC patients increased with the increase in human epididymis protein 4 (HE4) level (P < 0.05). The constructed nomogram model was tested, and the area under the curve (AUC) of the model was 0.934 (95% CI: 0.878-0.979), the calibration curve obtained a Brier of 0.084. Decision curve results showed that 68 out of every 100 EC patients could benefit without compromising the interests of others, with a benefit rate of 68%.

CONCLUSION

The occurrence of SLN in EC patients is related to their personal general characteristics, pathological characteristics, tumor markers, and other multi-dimensional indicators. The medical staff can evaluate the SLN risk of EC patients by combining multiple indicators.

The Association between Human Epididymis Secretory Protein 4 and Metabolic Syndrome

Individuals with metabolic syndrome (MetS) are known to have an increased risk of carcinogenesis. Human epididymis protein 4 (HE4) is a tumor marker and prognostic factor for epithelial ovarian carcinoma (EOC) patients. However, no studies have evaluated the association between MetS and HE4 levels. This study aimed to evaluate the relationship between HE4 levels and MetS in the National Health and Nutrition Examination Survey (NHANES 2001−2002). This cross-sectional analysis assessed all five components of MetS and HE4 levels in 2104 females (age ≥20 years) from the NHANES dataset. MetS was defined according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATPIII) criteria. The analysis indicated MetS in 593 individuals, and the β coefficient of their HE4 levels was 0.097 (95% CIs, 0.028−0.166, p = 0.006). Specifically, the β coefficients of the HE4 levels of participants with 1, 2, 3, and ≥4 features of MetS were 0.072 (95% confidence interval (CI): −0.015−0.159), 0.125 (95% CI: 0.030−0.220), 0.161 (95% CI: 0.053−0.270), and 0.242 (95% CI: 0.117−0.368), respectively, and all p values were <0.001. The p-value for the trend was <0.001. There was a significant association between the presence of MetS and HE4 levels. There were positive relationships between HE4 levels and an increased number of MetS components (with 1, 2, 3, and ≥4 features of MetS, all p values <0.001). Among the MetS components, low high-density lipoprotein levels and high triglyceride levels were independently associated with HE4 levels.

Associations of Uric Acid With Liver Steatosis and Fibrosis Applying Vibration Controlled Transient Elastography in the United States: A Nationwide Cross-Section Study

BACKGROUND AND OBJECTIVE

Serum uric acid (UA) is related to many metabolic diseases. However, the association of UA with liver diseases was not very clear. The objective of this study is to clarify the relationship of UA with liver steatosis and fibrosis.

METHODS

This is a cross-sectional study of 4364 people of National Health and Nutrition Examination Survey (NHANES) 2017-2018. Liver steatosis and fibrosis were assessed by controlled attenuation parameter (CAP) and liver stiffness measurements (LSM) using Vibration-controlled transient elastography (VCTE). Linear and logistic regressions were performed.

RESULTS

After adjusting for potential confounders, UA levels were associated with the prevalence of liver steatosis [OR=2.097 (95%CI: 1.245, 3.534)] and liver fibrosis [OR=2.983 (95%CI: 1.797, 4.952)]. Furthermore, the results were consistent in the subgroup analyses of males and females.

CONCLUSIONS

UA levels were positively associated with the prevalence of liver steatosis and fibrosis.