Diagnostic value of serum HE4 in endometrial cancer: a meta-analysis

Abstract

BackgroundEndometrial cancer (EC) is a common female malignant cancer. The age of incidence has become younger than before. If the diagnosis is during stage I, then the survival rate is about 90%. To date, there are no specific tumor markers for endometrial cancer. We usually use serum CA125 to help in diagnosing it. However, a serum biomarker CA125 greater than 35 U/ml is not useful in diagnosing EC at an early stage. Now, human epididymis protein 4 (HE4) has been intensively studied, and has been described as a new marker for ovarian cancer. The goal of this study was to evaluate the clinical value of serum HE4 in the diagnosis of endometrial cancer by meta-analysis.MethodsWe used MEDLINE, EMBASE, Cochrane Library and CBM databases to search the literature. The meta-analysis was performed by using Meta-Disc 1.4 software.ResultsAll data we obtained showed that the major advantage of HE4 lies in its specificity in endometrial cancer diagnosis. Its sensitivity in serum was not as high as expected. But this evidence is not enough.ConclusionsAdditional studies, particularly to evaluate HE4’s capability in identifying EC at an early stage, will be needed.

Utility of HE4 to identify patients with endometrioid endometrial cancer who may require lymphadenectomy

“…Recent studies suggest that HE4 also possesses a potential value as a biomarker in endometrial cancer. Serum HE4, measured during clinical follow-up, may identify a recurrent disease particularly in patients with endometrioid endometrial cancer [12] but we have not enough data to estimate its value in clinical practice [13].…”

Comparison of Serum Human Epididymis Protein 4 and Carbohydrate Antigen 125 as Markers in Endometrial Cancer

“…Among a wide spectrum of biomarkers, human epididymis protein 4 (HE4), which was identified in the epithelium of the distal epididymis by Kirchhoff et al 4 in 1991, has been considered as a novel tumor biomarker for malignant tumors such as ovarian cancer, 5Y8 lung cancer, 9 and EC. 10,11 To our knowledge, 2 meta-analyses have been performed to investigate screening value of serum HE4 for EC. 10,11 We believed that it would be more important and meaningful to compare the screening values between serum HE4 and the most commonly used biomarker CA125.…”

Biological markers with potential clinical value in endometrial cancer — review of the literature

“…Furthermore, the investigation showed no relations of HE4 to the pathological subtype but rather a strong relation to other factors like cancer stage, metastasis, myometrial invasion depth, recurrence, degree of differentiation and the overall survival rate. However, in another paper there was a lack of evidence to estimate the clinical value and to support the application of HE4 in EC [30]. In conclusion, further researches have to be carried out in order to evaluate the clinical specificity and sensitivity of HE4 and its benefits as a serum marker for EC.…”

“…It was concluded that matriptase elevation was associated with clinicopathological parameters such as advanced stage, high grade, myometrial invasion depth, cervical involvement, lymph node metastasis, lymph vascular space involvement and peritoneal cytology. Strong matriptase expression is therefore linked to an overall lower survival rate [30][31][32][33].…”