title: Human epididymis protein 4 offers superior specificity in the differentiation of benign and malignant adnexal masses in premenopausal women.
abstract: OBJECTIVE
  We sought to assess the ability of human epididymis protein 4 (HE4) and CA-125 to distinguish among benign, borderline, and malignant pelvic masses in premenopausal women.
  
  
  METHODS
  We conducted a subset analysis of data from a prospective clinical trial that enrolled women undergoing surgery for an adnexal mass. Diagnostic performance of CA-125 and HE4 for epithelial ovarian cancer (EOC) detection in premenopausal women was determined.
  
  
  RESULTS
  Of 229 premenopausal patients, 195 (85%) had benign masses, 18 (8%) had EOC, and 16 (7%) had borderline ovarian tumor. The sensitivity of CA-125 and HE4 for EOC detection was 83.3% and 88.9%, respectively. The specificity of CA-125 and HE4 was 59.5% and 91.8%, respectively. A normal HE4 level ruled out invasive cancer in 98% of women with an elevated CA-125.
  
  
  CONCLUSIONS
  HE4 offers superior specificity compared to CA-125 for the differentiation of benign and malignant adnexal masses in premenopausal women.
authors: Department of Obstetrics and Gynecology, New York-Presbyterian Hospital, New York, NY, USA. keh2004@med.cornell.edu
authors: Kevin
authors: K
authors: Holcomb
authors: Zivjena
authors: Z
authors: Vucetic
authors: M Craig
authors: MC
authors: Miller
authors: Robert C
authors: RC
authors: Knapp
mesh_terms: D000291:Adnexal Diseases / Q000097:blood* / Q000175:diagnosis*; D018394:CA-125 Antigen / Q000097:blood*; D003937:Diagnosis, Differential; D030501:Epididymal Secretory Proteins / Q000032:analysis*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000097:blood* / Q000175:diagnosis*; D017697:Premenopause; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D023083:beta-Defensins
chemical_list: D018394:CA-125 Antigen; C426184:DEFB126 protein, human; D030501:Epididymal Secretory Proteins; D023083:beta-Defensins