title: Evaluating the clinical significance of serum HE4 levels in lung cancer and pulmonary tuberculosis.
abstract: OBJECTIVE
  To evaluate whether serum human epididymis protein 4 (HE4) levels could be used as a marker to differentiate lung cancer from pulmonary tuberculosis (PTB) and as a prognostic indicator in patients with non-small-cell lung cancer (NSCLC).
  
  
  METHODS
  HE4 levels were measured in serum samples from 106 healthy controls, 190 lung cancer patients, 114 patients with PTB and 24 patients with pneumonia using enzyme-linked immunosorbent assay.
  
  
  RESULTS
  Serum HE4 levels in lung cancer patients were significantly higher than those in patients with PTB and healthy controls (P < 0.001). Using the optimal cut-off value of 94.01 pmol/l, HE4 levels distinguished lung cancer from PTB with a sensitivity of 61.6% and a specificity of 93.0%. After adjusting for age and smoking status, a binary unconditional logistic regression model provided a sensitivity of 67.4% and a specificity of 86.0% for differentiating between these two diseases. In the NSCLC group, serum HE4 levels were significantly higher in patients at advanced stages (Stage I-II vs. Stage III-IV, P = 0.02). Higher levels of serum HE4 (≥ 83.90 pmol/l) were significantly correlated with a worse 3-year survival rate for patients with NSCLC (P < 0.05).
  
  
  CONCLUSIONS
  Serum HE4 may be used as a potential marker to differentiate lung cancer from PTB and healthy controls. In addition, higher levels of HE4 predict poor prognosis in NSCLC patients.
authors.affiliation: State Key Laboratory of Oncology in Southern China, and Department of Clinical Laboratory Medicine, Sun Yat-Sen University Cancer Centre, Guangzhou, China.
authors.forename: W
authors.initials: W
authors.lastname: Liu
authors.forename: J
authors.initials: J
authors.lastname: Yang
authors.forename: P-D
authors.initials: PD
authors.lastname: Chi
authors.forename: X
authors.initials: X
authors.lastname: Zheng
authors.forename: S-Q
authors.initials: SQ
authors.lastname: Dai
authors.forename: H
authors.initials: H
authors.lastname: Chen
authors.forename: B-L
authors.initials: BL
authors.lastname: Xu
authors.forename: W-L
authors.initials: WL
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D016022:Case-Control Studies; D003937:Diagnosis, Differential; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D016015:Logistic Models; D008175:Lung Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011014:Pneumonia / Q000097:blood / Q000175:diagnosis; D011379:Prognosis; D011506:Proteins / Q000378:metabolism*; D012680:Sensitivity and Specificity; D015996:Survival Rate; D014397:Tuberculosis, Pulmonary / Q000097:blood / Q000175:diagnosis*; D000081102:WAP Four-Disulfide Core Domain Protein 2
chemical_list: D014408:Biomarkers, Tumor; D011506:Proteins; D000081102:WAP Four-Disulfide Core Domain Protein 2; C569698:WFDC2 protein, human