title: Potential role of HE4 in multimodal screening for epithelial ovarian cancer.
abstract: In screening for epithelial ovarian cancer, unnecessary surgery can be reduced by limiting use of transvaginal ultrasound (TVU) to women with increasing CA125 serum levels. Replacing or augmenting TVU with measurement of a serum marker specific for malignancy might further improve screening performance. Serum samples from 112 invasive ovarian cancer patients and 706 matched control subjects from the Prostate, Lung, Colorectal, and Ovarian trial were used to evaluate human epididymis protein 4 (HE4), mesothelin, matrix metalloproteinase 7 (MMP7), SLPI, Spondin2, and insulin-like growth factor binding protein 2 (IGFBP2) for their potential use in screening. TVU results were available for a subset of 84 patients and 516 control subjects used to compare the best marker with TVU. HE4 was found to perform better than TVU as a second-line screen, confirming 27 of 39 cancers with increasing CA125 serum levels compared with 17 cancers confirmed by TVU (P = .03). Serum HE4 levels were found to increase with age and smoking status, suggesting that a longitudinal algorithm might improve its performance.
authors.affiliation: Molecular Diagnostics Program, Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, USA. nurban@fhcrc.org
authors.forename: Nicole
authors.initials: N
authors.lastname: Urban
authors.forename: Jason D
authors.initials: JD
authors.lastname: Thorpe
authors.forename: Lindsay A
authors.initials: LA
authors.lastname: Bergan
authors.forename: Robin M
authors.initials: RM
authors.lastname: Forrest
authors.forename: Archana V
authors.initials: AV
authors.lastname: Kampani
authors.forename: Nathalie
authors.initials: N
authors.lastname: Scholler
authors.forename: Kathy C
authors.initials: KC
authors.lastname: O'Briant
authors.forename: Garnet L
authors.initials: GL
authors.lastname: Anderson
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Cramer
authors.forename: Christine D
authors.initials: CD
authors.lastname: Berg
authors.forename: Martin W
authors.initials: MW
authors.lastname: McIntosh
authors.forename: Patricia
authors.initials: P
authors.lastname: Hartge
authors.forename: Charles W
authors.initials: CW
authors.lastname: Drescher
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood*; D018394:CA-125 Antigen / Q000097:blood; D002277:Carcinoma / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D030501:Epididymal Secretory Proteins / Q000378:metabolism*; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012907:Smoking / Q000097:blood; D014463:Ultrasonography / Q000379:methods; D014621:Vagina; D023083:beta-Defensins
chemical_list: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; C426184:DEFB126 protein, human; D030501:Epididymal Secretory Proteins; D023083:beta-Defensins