Prospective evaluation of 92 protein biomarkers for early detection of endometrial cancer

The human epididymis protein 4 (HE4) remains the best available endometrial cancer (EC) biomarker; however, its discrimination between cases and cancer-free individuals is limited and might be improved when combined with other protein markers. We evaluated the discrimination capacity of 92 proteins...

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Main Authors: Cooley, Victoria (Author) , Turzanski Fortner, Renée (Author) , Mukama, Trasias (Author) , Naudin, Sabine (Author) , Pala, Valeria (Author) , Dossus, Laure (Author) , Gram, Inger T. (Author) , Olsen, Karina Standahl (Author) , Sánchez, Maria-Jose (Author) , Israelsson, Pernilla (Author) , Allen, Naomi (Author) , Langseth, Hilde (Author) , Kaaks, Rudolf (Author)
Format: Article (Journal)
Language:English
Published: Aug 2025
In: International journal of cancer
Year: 2025, Volume: 157, Issue: 3, Pages: 480-489
ISSN:1097-0215
DOI:10.1002/ijc.35428
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1002/ijc.35428
Verlag, kostenfrei, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1002/ijc.35428
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Author Notes:Victoria Cooley, Renée Turzanski Fortner, Trasias Mukama, Sabine Naudin, Valeria Pala, Laure Dossus, Inger T. Gram, Karina Standahl Olsen, Maria-Jose Sánchez, Pernilla Israelsson, Naomi Allen, Hilde Langseth, Rudolf Kaaks

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520 |a The human epididymis protein 4 (HE4) remains the best available endometrial cancer (EC) biomarker; however, its discrimination between cases and cancer-free individuals is limited and might be improved when combined with other protein markers. We evaluated the discrimination capacity of 92 proteins as potential early detection biomarkers for EC in nested case-control studies in the European Prospective Investigation into Cancer and Nutrition (EPIC) (63 cases, 123 controls) and Janus (75 cases, 146 controls) cohorts, evaluating blood samples taken ≤2 years prior to diagnosis. Proteins were measured with the Olink Target 96 Oncology II panel assays. Areas under the receiver operating characteristic curves (AUCs) were calculated using logistic regression. The discrimination between cases and controls of top-performing proteins was modest (EPIC: HE4, CA125, CAIX, and S100A4; Janus: HE4, CA125, FURIN, CXCL13, and IL6; AUC range: 0.65 [S100A4], 0.76 [HE4, EPIC] within 0 to <12 months of blood collection) and decreased as the time between blood draw and cancer diagnosis increased (12-24 months AUC range: 0.49 [S100A4], 0.69 [CA125, Janus]). The combination of these other markers with HE4 did not improve discrimination. HE4 and other candidate proteins had limited discrimination between EC cases and controls and hence do not appear to be useful for early detection of this disease in women at average population risk. 
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