The utility of serum human epididymis protein 4 (HE4) in patients with a pelvic mass.
OBJECTIVE
Although CA125 is the most widely used cancer marker in the diagnostic approach of pelvic masses in women, its clinical usefulness is limited because it lacks expression of the antigen in the early stages of disease. The human epididymis protein 4 (HE4) is frequently over-expressed in ovarian cancer, whereas its expression in normal tissues, including the ovary, is low. The aim of this study was to assess the concentration of both HE4 and CA125 in patients with different forms of benign and malign pelvic masses.


METHODS
The study population included 99 patients with gynecological cancer (46 ovarian, 39 endometrial, 14 cervical) and 40 affected by benign disease (22 endometriosis and 18 benign ovarian mass). Twelve control subjects were also included in the study. In all the patients, serum samples were collected on the day before scheduled surgery.


RESULTS
The median CA125 and HE4 serum levels were significantly higher among ovarian cancer patients as compared with healthy subjects and with those with benign mass, cervical, and endometrial tumors. The receiver operating characteristics curve analysis on healthy controls and patients with ovarian cancers revealed that HE4 had a significantly higher area under the curve when compared with CA125 (0.99 vs. 0.91), with a sensibility and specificity of 98 and 100%, respectively.


CONCLUSIONS
HE4 seems to be a promising ovarian cancer marker, and its measurement might improve the diagnostic approach to patients with pelvic masses.
Montagnana
Martina
M
Sezione di Chimica Clinica, Dipartimento di Scienze Morfologico-Biomediche, Università degli Studi di Verona, Verona, Italy. martina.montagnana@med.lu.se
Lippi
Giuseppe
G
Ruzzenente
Orazio
O
Bresciani
Valentina
V
Danese
Elisa
E
Scevarolli
Silvia
S
Salvagno
Gian Luca
GL
Giudici
Silvia
S
Franchi
Massimo
M
Guidi
Gian Cesare
GC
D016022:Case-Control Studies; D030501:Epididymal Secretory Proteins / Q000378:metabolism*; D005260:Female; D006801:Humans; D047908:Intracellular Signaling Peptides and Proteins; D010051:Ovarian Neoplasms / Q000097:blood; D010386:Pelvic Neoplasms / Q000097:blood*; D011506:Proteins / Q000378:metabolism; D012372:ROC Curve; D023083:beta-Defensins
C426184:DEFB126 protein, human; D030501:Epididymal Secretory Proteins; D047908:Intracellular Signaling Peptides and Proteins; C549756:NBR1 protein, human; D011506:Proteins; D023083:beta-Defensins