Clinical efficacy of serum human epididymis protein 4 as a diagnostic biomarker of ovarian cancer: A pilot study

Abstract

ObjectiveTo compare accuracy of serum human epididymis protein 4 (HE4) levels with cancer antigen 125 (CA-125) levels as biomarkers for ovarian cancer.MethodsThe study population included 94 Korean women, including 32 patients with a diagnosis of ovarian cancer and 62 patients with a diagnosis of benign ovarian tumor. All diagnoses were confirmed by histopathological analysis. Serum HE4 levels were assessed using an HE4 enzyme immunoassay, which were performed according to the manufacturer's instructions. Serum CA-125 levels were determined using a Modular analytics E170 module.ResultsThe median serum CA-125 and HE4 levels were significantly higher in patients with ovarian cancer than those with other benign tumors (CA-125, 394.1 U/mL vs. 22.7 U/mL; HE4, 56.7 pM vs. 18.5 pM; P < 0.05 in both). An additional comparison revealed that the patients with endometriosis had greater median serum CA-125 levels than those with other benign ovarian tumors (32.0 U/mL vs. 17.9 U/mL, P = 0.03). Conversely, the median serum HE4 levels were similar among the two benign ovarian tumor groups, with no statistically significant difference observed (19.0 pM vs. 18.2 pM, P = 0.49). The receiver operating characteristics curve analysis for the benign ovarian tumor and ovarian cancer patients showed that HE4 showed a greater area under the curve with borderline significance when compared with CA-125 in both groups (0.93 vs. 0.85).ConclusionSerum HE4 levels may not only allow for the detection of ovarian cancer, but also allow for better differentiation of cases of ovarian cancer versus other benign ovarian tumors compared with serum CA-125.

Combined detection of sialic acid and hydroxyproline in diagnosis of ovarian cancer and its comparison with human epididymis protein 4 and carbohydrate antigen 125

“…Other results of HE4 and CA125 are mostly consistent with previous studies [29,30]. The ROC curves demonstrate that serum SA and Hyp had better efficacy than HE4 (P = 0.0017) and CA125 (P b 0.001) in differentiating patients with gynecologic malignancies from patients with benign gynecologic diseases and healthy individuals.…”

Role of human epididymis protein 4 in chemoresistance and prognosis of epithelial ovarian cancer

“…It is not expressed in normal ovarian surface epithelium . However, HE4 is overexpressed in ovarian cancer cells and secreted to the sera in the patients with ovarian cancer …”

“…7 However, HE4 is overexpressed in ovarian cancer cells and secreted to the sera in the patients with ovarian cancer. 8,9 Despite its clinical utility as a biomarker for ovarian cancer, the role of HE4 in ovarian cancer is not understood.…”

Tissue CA125 and HE4 Gene Expression Levels Offer Superior Accuracy in Discriminating Benign from Malignant Pelvic Masses

“…Among a wide spectrum of serum biomarkers proposed to aid in the diagnosis of women presenting with a suspicious pelvic mass, human epididymis protein 4 (HE4), has been introduced as a novel biomarker for ovarian cancer diagnosis (Hellström et al, 2003;Su et al, 2013). HE4 was found to offer a better diagnostic performance than CA125 for distinguishing between benign and malignant pelvic masses (Holcomb et al, 2011;Zheng and Gao, 2012;Chung et al, 2013). Regardless of its beneficial characteristics, similar to classic tumor markers (Trapé et al, 2011), HE4 has some limitations in the detection of tumors, where its level may be elevated in benign diseases without evidence of malignancy (Hertlein et al, 2012).…”