title: Serum HE4 concentration is not dependent on menstrual cycle or hormonal treatment among endometriosis patients and healthy premenopausal women.
abstract: OBJECTIVE
  Human epididymal secretory protein E4 (HE4) is a new promising tumor marker developed for the diagnostics and follow up of ovarian cancer. It has yet to become widely accepted in clinical practice, and its biological properties have not been inclusively studied. The aim of this study was to investigate whether serum HE4 concentration varies within the normal menstrual cycle and whether common gynecological hormonal treatments have an effect on HE4 values.
  
  
  METHODS
  Our study population consisted of 180 women, including 126 endometriosis patients and 54 healthy women. We measured their serum HE4 and CA125 concentrations and evaluated the effect of the menstrual cycle and the possible hormonal medication on these marker concentrations.
  
  
  RESULTS
  We found no significant variation in serum HE4 concentrations in samples taken at different phases of the menstrual cycle. The median HE4 concentrations in proliferative, secretory and menstrual phase were 41.5, 45.1 and 35.3 pM in healthy women, and 43.4, 44.3 and 43.0 pM in endometriosis patients, respectively. The use of combined estrogen and progestin contraceptives did not affect serum HE4 levels significantly.
  
  
  CONCLUSIONS
  The present study shows that the HE4 measurement in healthy premenopausal women as well as in women with endometriosis can be carried out at any phase of the menstrual cycle, and irrespective of hormonal medication, extending the benefits of HE4 use in clinical practice.
authors.affiliation: Department of Obstetrics and Gynecology, Turku University Hospital, FI-20520 Turku, Finland. makantt@utu.fi
authors.forename: M
authors.initials: M
authors.lastname: Hallamaa
authors.forename: P
authors.initials: P
authors.lastname: Suvitie
authors.forename: K
authors.initials: K
authors.lastname: Huhtinen
authors.forename: J
authors.initials: J
authors.lastname: Matomäki
authors.forename: M
authors.initials: M
authors.lastname: Poutanen
authors.forename: A
authors.initials: A
authors.lastname: Perheentupa
mesh_terms: D000328:Adult; D047072:Aromatase Inhibitors / Q000008:administration & dosage; D014408:Biomarkers, Tumor / Q000097:blood*; D018394:CA-125 Antigen / Q000097:blood; D016022:Case-Control Studies; D003277:Contraceptives, Oral, Combined / Q000008:administration & dosage; D004715:Endometriosis / Q000097:blood* / Q000188:drug therapy*; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives; D006728:Hormones / Q000008:administration & dosage*; D006801:Humans; D008565:Membrane Proteins / Q000097:blood; D008597:Menstrual Cycle / Q000097:blood* / Q000187:drug effects; D008875:Middle Aged; D017697:Premenopause / Q000097:blood*; D011372:Progestins / Q000008:administration & dosage; D011506:Proteins / Q000378:metabolism*; D000081102:WAP Four-Disulfide Core Domain Protein 2; D055815:Young Adult
chemical_list: D047072:Aromatase Inhibitors; D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D003277:Contraceptives, Oral, Combined; D006728:Hormones; C451759:MUC16 protein, human; D008565:Membrane Proteins; D011372:Progestins; D011506:Proteins; D000081102:WAP Four-Disulfide Core Domain Protein 2; C569698:WFDC2 protein, human; D007987:Gonadotropin-Releasing Hormone