Serum HE4 concentration is not dependent on menstrual cycle or hormonal treatment among endometriosis patients and healthy premenopausal women

Comparison of ovarian cancer markers in endometriosis favours HE4 over CA125

“…A previous study investigated a large patient cohort (>1,000 patients) with benign gynaecological diseases, including endometriosis, and revealed an increased specificity of HE4 over CA125 as a result of less frequently increased levels in these females, particularly in the pre-menopausal group (35). The present findings in the PF are parallel with a previous study in the serum (38) regarding the cycle phases and the two markers, however, not for HE4 regarding the presence of endometriosis. Another previous study compared the serum levels of these markers between ovarian cancer and different endometriotic pathologies, and demonstrated that measuring both markers in the same sample made it possible to distinguish between the two pathologies, since HE4 but not CA125, was shown to be increased in endometriotic pathology (36).…”

“…or between the proliferative and secretory menstrual cycle phases (38). The same result was obtained following different hormone treatments, however, in these groups, particularly for GnRHa, the number of patients assessed was significantly smaller compared with that of the present study.…”

Physiopathological factors affecting the diagnostic value of serum HE4-test for gynecologic malignancies

“…However, no difference was found in women older than 35 years. A contradictory result was reported by Hallamaa et al in a study covering 180 women, aged between 19 and 48 years, including 54 asymptomatic women and 124 endometriosis patients [45]. The study subjects were classified into five subgroups with the use of histopathological criteria, including nondiagnostic, proliferative, secretory, inactive/atrophic, and menstrual ones.…”

“…It is noteworthy, however, that the millimolar concentration of estrogen applied in this study was many orders higher than the physiological levels. On the other hand, it was reported that hormonal medication for endometriosis patient did not cause changes in the HE4 serum concentration [45]. Recently, Chen et al investigated the role of estradiol (E2) on expression of HE4 [55].…”

HE4 Tissue Expression and Serum HE4 Levels in Healthy Individuals and Patients with Benign or Malignant Tumors: A Systematic Review

“…Furthermore, significantly higher median HE4 levels in serum are measured in postmenopausal women compared with premenopausal (P < 0.001; refs. 36,38), and serum HE4 varies within the different phases of the menstrual cycle (39,40).…”