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CompletedNCT03498924Updated Feb 11, 2020

Identification and Characterization of Endometrial Cancer With Specific Tumor Markers in Serum and Endometrial Tissue

An observational study in Endometrial Neoplasm Malignant, sponsored by Fundación Investigación Sanitaria en León. Completed at 1 site in Spain. Open to female participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2020-02-11.

Sponsored by Fundación Investigación Sanitaria en León · Observational

Study type
Observational
Model
Case-control
Time perspective
Prospective
Enrollment
80
Ages
18 Years and older
Sex
Female
01

Where this study stands

Counted across the records on this site · 2026-11-12

Among 130 studies in Endometrial Neoplasms with a site in Spain — 53 open to participants now, 77 under way, 16 of them phase 3. Endometrial Neoplasms · Spain.

Enrollment
13th of 14
80 · median 176
Started
2017
with 4 others
Observational
14 of 130
8 open now
Registered
34th of 130
by date

Among the 130 studies in Endometrial Neoplasms with a site in Spain, this one is the 13th largest by enrollment of the 14 observational ones, is one of 5 that started in 2017, is one of 14 observational ones, and was the 34th registered.

By phase

130 studies; the count open now beside each. This study's row is marked.

Phase 132 · 11 open
Phase 1/231 · 17 open
Phase 326 · 6 open
Phase 222 · 9 open
Observationalthis study14 · 8 open
No phase4 · 1 open
Phase 2/31 · 1 open

By the year they started

First in 1988; this study’s year is marked. 5 started in 2017.

Size and results

Median enrollment 250 across the 115 interventional studies, 176 across the 14 observational. Of the 48 that completed or were terminated, 16 (33%) have results posted.

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02

Study summary

Endometrial cancer is the most common malignant tumor of the female genital tract in our means. The diagnosis is made by endometrial biopsy sampling with anatomopathological analysis which pinpoints the cell line and the level of cell differentiation. Its treatment is surgical with adjuvant treatment (chemotherapy or radiotherapy) besides, depending on the staging. Thus far, in the first diagnosis it is only request the tumor marker CA125 in serum, but there are studies that identify the HE4 protein in blood as a feasible marker for endometrial cancer. Furthermore, the staging changes the surgical and the adjuvant treatment: in its early stages, surgery is based on hysterectomy and double adnexectomy, however, in later stages it is necessary to add pelvic and paraaortic lymphadenectomy with the associated comorbidity. This makes extremely important that the preoperative diagnosis is accurate. The aim of this study is to identify and characterize the HE4, Ki67, p53 and other potential biomarkers in endometrial tissue in order to diagnose patients with disease only with a biopsy. Moreover, the investigators are searching for connections among these markers and prognostic factors such as grade of cell differentiation, cell line, lymphatic affectation, tumor stage or even features as survival or disease free survival.

Read the detailed description

List of abbreviations:

  • HE4: Human Epididymis Protein 4
  • CA125: Carbohydrate Antigen 125
  • Ki67: antigen KI67
  • EC: Endometrial Cancer
  • CT: Computed Tomography
  • NMR: Nuclear Magnetic Resonance
  • FIGO: International Federation of Gynecology and Obstetrics

The purpose of this study is:

  • The proportion of positive H-score of HE4, as quantified in endometrial tissue. It is significantly higher in patients with endometrial cancer than in non-EC patients.
  • Percentage of HE4, CA125 and other markers positives in cases and controls.
  • Concentration of HE4 in tissue, as measured by H-score, correlates linearly with HE4 concentration in serum, as measured in terms of ppmol/l.
  • Differences in serum CA125 levels between cases and controls.
  • Quantification of tissue tumor markers of EC patients, per disease stages.
  • Relation of the immunohistochemistry intensity with survival and disease-free survival times.
  • Analysis of other risk factors adjusting for known variables like age, menopausal status, hypertension, diabetes or obesity.
  • Feasibility of the technique.

Steps in the study:

  1. Patients enter the study when a diagnosis of endometrial cancer is done. As it is ordinary in the clinical practice the diagnosis is made with an endometrial tissue sample taken in the office which is afterwards studied by a pathologist, who makes the final diagnosis.
  2. Patients undergo the regular preoperative study with pelvic ultrasound, CT and/or NMR for the extension study, blood tests and the preanaesthetic consultation. As it is registered in the protocol of Endometrial Cancer Treatment.
  3. Then a matched control is selected from the group of patients that are going to be hysterectomized for other non-malignant reasons (abdominal way, vaginal, or laparoscopic way). Variables considered for matching are: age (variability of five years), pre or postmenopausal status, hypertension, obesity and diabetes.
  4. Every patient then is asked for accept and sign the informed consent. The next step is to prepare the patient for the surgery. In this moment the serum sample is taken. Subsequently the surgery will be performed.
  5. Then the anatomopathological study is conducted over the preoperative tissue sample. HE4 marker in endometrial tissue is defined by H-Score while Ki67 and p53 are defined as usual. Although Ki67 is matched in > or \<25% of expression instead of 14% as it is made in breast cancer tissue samples.
  6. After discharge, the patient will be follow-up for two years in order to register the evolution of the disease.
03

Conditions studied

  • Endometrial Neoplasm Malignant

Keywords

  • tumor marker
  • HE4
  • CA125
  • staging
  • diagnosis
  • Endometrial Cancer
04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
Female
Accepts healthy volunteers
Yes
Sampling method
Probability sample

Study population

Every patient who is treated in Hospital de Leon of endometrial disease between August 2017 and the end of the recruitment

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Female
  • Of legal age (≥ 18 years)
  • Wish to participate in the research study and sign consent forms voluntarily
  • Patients diagnosed of endometrial cancer derived to hysterectomy

Exclusion criteria

Exclusion Criteria:

  • Patients that underwent surgery for other malignant pathologies, whether for ovarian carcinoma, cervical carcinoma or uterine sarcoma.
05

Study design

Observational model
Case-control
Time perspective
Prospective
Enrollment
80 participants (actual)
Patient registry
No
Biospecimen retention
Samples with dna

Groups and cohorts

  • CASES

    Patients with endometrial cancer

    Diagnostic Test: Measure of biomarkers in serum and endometrial tissue

  • CONTROLS

    Matched controls without neoplasm disease

    Diagnostic Test: Measure of biomarkers in serum and endometrial tissue

Interventions

  • Diagnostic testMeasure of biomarkers in serum and endometrial tissue

    Blood sample and endometrial sample

06

What researchers measure

Primary outcomes

  1. The proportion of positive H-score of HE4.

    HE4 quantified in endometrial tissue is significantly higher in patients with endometrial cancer than in non-EC patients

    Time frame: Two years

Secondary outcomes

  1. Concentration of HE4 in tissue correlates linearly with HE4 in serum.

    Comparison of tissue H-score with ppmol/L in serum

    Time frame: Two years

  2. Difference in preoperative serum CA125 levels in cases and controls.

    Measured in terms of U/mL

    Time frame: Two years

  3. Difference in preoperative serum HE4 levels in cases and controls.

    Measured in terms of ppmol/L

    Time frame: Two years

  4. Disease stages

    FIGO stages: postsurgical classification drawn up to define the extent of spread of genital cancer

    Time frame: Two years

  5. Tissue tumor marker HE4

    H-score determination: Immunohistochemistry results can be evaluated by a semiquantitative approach used to assign an H-score (or "histo" score) to tumor samples. Cytoplasmic staining will be graded for intensity (0-negative, 1-weak, 2-moderate and 3-strong) and the percentage of positive cells was scored as 0 (0%), 1 (1-10%), 2 (11-50%) and 3 (51-100%). Single scale with scores 0-9 will be obtained by multiplying the intensity and the percentage staining score, and a total score will be calculated by grouping score 0 in total score 0, 1-3 in total score 1, 4-6 in total score 2 and 7-9 in total score 3. The assumption is that as higher is the score the level of cell differentiation would be minor.

    Time frame: Two years

  6. Relation of the immunohistochemistry intensity in H-score with overall survival

    HE4 biomarker measured with H-score in endometrial tissue, explained in outcome 5, in relation to length of time of survival

    Time frame: Through study completion, an average of 2 years

  7. Relation of the immunohistochemistry intensity in H-score with disease-free survival

    HE4 biomarker measured with H-score in endometrial tissue, explained in outcome 5, in relation to length of time after primary treatment that the patient survives without any signs or symptoms of that cancer.

    Time frame: Through study completion, an average of 2 years

  8. Analysis of outcomes in relation to age

    Age of patients is one of the known risk factors for EC, we are going to analysis the results of the study with this variable. As elder the relative risk is higher though there is no accurate cut-off point.

    Time frame: Two years

  9. Analysis of outcomes in relation to menopausal status

    Menopausal status is determined by questionnaire during the preoperative consultant. It is another risk factor for EC, the postmenopausal status has higher relative risk than premenopausal status.

    Time frame: Two years

  10. Analysis of outcomes in relation to hypertension

    Hypertension is diagnosed previously to surgery as Blood Pressure over 140/90 mm Hg in several measures. There is a known high relative risk of EC in patients diagnosed with hypertension.

    Time frame: Two years

  11. Analysis of outcomes in relation to diabetes

    Diabetes is a disease previously diagnosed by high glucose levels in blood. There is a known high relative risk of EC in patients diagnosed with diabetes.

    Time frame: Two years

  12. Analysis of outcomes in relation to obesity

    Obesity is defined as BMI \>27 kg/m2. There is a known high relative risk of EC in patients diagnosed with obesity.

    Time frame: Two years

07

Study locations

1 site
  • Tatiana Cuesta-Guardiola
    Leon, 24080, Spain
08

References and documents

Publications

  • Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin. 2018 Jan;68(1):7-30. doi: 10.3322/caac.21442. Epub 2018 Jan 4. PubMed 29313949 ↗
  • Creasman WT, Morrow CP, Bundy BN, Homesley HD, Graham JE, Heller PB. Surgical pathologic spread patterns of endometrial cancer. A Gynecologic Oncology Group Study. Cancer. 1987 Oct 15;60(8 Suppl):2035-41. doi: 10.1002/1097-0142(19901015)60:8+3.0.co;2-8. PubMed 3652025 ↗
  • Li X, Gao Y, Tan M, Zhuang H, Gao J, Hu Z, Wang H, Zhu L, Liu J, Lin B. Expression of HE4 in Endometrial Cancer and Its Clinical Significance. Biomed Res Int. 2015;2015:437468. doi: 10.1155/2015/437468. Epub 2015 Oct 11. Erratum In: Biomed Res Int. 2018 Sep 12;2018:6795629. doi: 10.1155/2018/6795629. PubMed 26539494 ↗
  • Bignotti E, Ragnoli M, Zanotti L, Calza S, Falchetti M, Lonardi S, Bergamelli S, Bandiera E, Tassi RA, Romani C, Todeschini P, Odicino FE, Facchetti F, Pecorelli S, Ravaggi A. Diagnostic and prognostic impact of serum HE4 detection in endometrial carcinoma patients. Br J Cancer. 2011 Apr 26;104(9):1418-25. doi: 10.1038/bjc.2011.109. Epub 2011 Apr 5. PubMed 21468050 ↗

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Aug 2017 to primary completion in Aug 2018, 12 months.

Of 130 non-industry observational studies under Endometrial Neoplasms, half reached primary completion within 105 months of starting (the median), counting those still running; a quarter within 32 and three quarters within 206. This study's 12 months is below that.

Counting every sponsor, half of 150 studies reached it within 105 months; a quarter within 32 and three quarters within 207.

How these figures are worked out, and which studies are left out of them.

Registered
Feb 23, 2018
First posted
Apr 17, 2018
StartActual
Aug 1, 2017
Primary completionActual
Aug 1, 2018
CompletionActual
Jun 1, 2019
Last update
Feb 11, 2020
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Feb 11, 2020, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03498924
Lead sponsor
Fundación Investigación Sanitaria en León
Responsible party
Tatiana Cuesta-Guardiola (Principal investigator, Fundación Investigación Sanitaria en León) — Principal investigator
First posted
Apr 17, 2018
Start date
Aug 1, 2017
Primary completion
Aug 1, 2018
Completion
Jun 1, 2019
Last update
Feb 11, 2020

Study contacts

Tatiana Cuesta-Guardiola, Medicine
principal investigator · Hospital de Leon

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Feb 2020. You cannot join it, but the record below documents what was studied.

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