Kanokwan Promchit

Human Epididymis Protein 4 (HE4) and Cancer Antigen 125 (CA125) for Prediction of Optimal Primary Surgery in Non-Mucinous Epithelial Ovarian Cancer

To determine the relationship between pre-operative HE4 and CA125 levels in non-mucinous epithelial ovarian cancer cases (EOC) and outcomes of primary surgery for prediction of optimal surgery. A retrospective study was performed on non-mucinous EOC who underwent primary surgery at King Chulalongkorn Memorial Hospital from 2016 to 2020. Demographic and clinical characters were collected. Histopathology and pre-operative tumor markers namely HE4 and CA125 were also recruited. Primary surgical outcomes were classified as optimal (OS) and suboptimal surgery (SS). One hundred and seventy patients were enrolled in the study. There were 130 and 40 cases in OS and SS, respectively. Average age and body mass index (BMI) of EOC were 54.2 years old and 23.1 Kg/m2, respectively. Both groups had comparable demographic characteristics. Two-thirds (103/170) and one-third (63/170) had early stage and clear cell histopathology, respectively. The median level of HE4 were 118.60 and 603.45 pmol/L in OS and SS, respectively. OS and SS had average CA125 at 146.95 and 814.70 U/L, respectively. The best cut-off point of HE4 and CA125 less than 170.95 pmol/L and 316.4 U/mL gave predicting OS with area under curve (AUC) at 0.78 and 0.75, respectively. HE4 and CA125 cut-off point had sensitivity, specificity, positive predict value (PPV) and negative predictive value (NPV) at percentage of 60.8/60.8, 87.5/82.5, 94.1/91.9 and 40.7/39.3, respectively. HE4 and CA125 of non-mucinous EOC among OS had significantly less than SS and could be the predicting of optimal surgery.

Experience of Cervical Cytology and High-Risk HPV Testing (Physician vs Self-Collected) for Primary Cervical Cancer Screening in an Urban Hospital of Thailand

To explore the experience of conventional Pap smear (CPS), physician-collected HPV (pHPV) and self-collected HPV test (sHPV) for cervical cancer (CC) screening in the general population in the north-eastern region of Thailand. A retrospective study was conducted among women who visited the gynecology and colposcopy clinic in Kuchinarai Crown Prince Hospital for CC screening between January 2020 and December 2023. Participants received counselling before choosing between CPS, pHPV, and sHPV testing. Data reviewed from medical records included age, parity, CC screening results, colposcopy results, and treatment. A total of 5,984 women were enrolled in the study. There were 1,727, 2,962 and 1,295 cases in the CPS, pHPV, and sHPV, respectively. The average age of participants was 40.6, 49.5 and 47.6 years old in the CPS, pHPV, and sHPV, respectively. Percentage of multiparous participants were 86.3, 94.4 and 93.8 in CPS, pHPV and sHPV, respectively. Positive test results from the CPS, pHPV, and sHPV were 1.4, 5.7, and 6.8 percent, respectively with statistical significance. Return to colposcopy of CPS (62.5%) was highest and followed by pHPV (35.3%) and sHPV (18.2%) groups with statistical significance. Detection rate of CIN2+/CIN 3+ were 0.1/0.1, 0.5/0.4 and 0.2/0.2 percent from CPS, sHPV, and sHPV groups, respectively with statistical significance. Primary HPV and CPS testing had comparable reliability and acceptability for CC screening among Thai women. High missing rate for reflexed cytology or colposcopy of sHPV was a major issue.