Indian journal of Medical Biochemistry

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VOLUME 23 , ISSUE 2 ( May-August, 2019 ) > List of Articles

Original Article

Serum Human Epididymus Protein-4 (HE4) as a Biomarker in Ovarian Cancer and its Comparison with CA-125 in Benign and Malignant Cases

Swarnima Singh, Narayan Singh Jyala, Uday Kumar, Rekha Kumari

Keywords : Biomaker, Carbohydrate antigen125, HE4, Human epididymis protein 4, Ovarian cancer

Citation Information : Singh S, Jyala NS, Kumar U, Kumari R. Serum Human Epididymus Protein-4 (HE4) as a Biomarker in Ovarian Cancer and its Comparison with CA-125 in Benign and Malignant Cases. Indian J Med Biochem 2019; 23 (2):242-246.

DOI: 10.5005/jp-journals-10054-0095

License: CC BY-NC 4.0

Published Online: 01-08-2019

Copyright Statement:  Copyright © 2019; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction: Ovarian cancer is the third leading site of cancer among women in India. 70% of ovarian cancers are diagnosed with advanced disease leading to high fatality rate. Human epididymis protein 4 (HE4), also known as WAP four disulphide core 2 (WFDC2), is a novel protein and is one of the more promising biomarkers for improving diagnostic performance in ovarian cancer detection. Aim: To evaluate a new tumor marker, HE4, in comparison with CA-125 in diagnosis of ovarian cancer and benign gynecological diseases. Material and Methods: Pre-operative serum HE4 and CA-125 were determined in 146 patients with benign gynecologic diseases and 100 patients with malignant gynecologic cancers (64 were epithelial ovarian cancers patients). HE4 and CA-125 cutoffs were 140 pmol/L and 35 kU/L, respectively. Sandwich Elisa, biotin-labelled antibody kit was used for HE4. Results: HE4 demonstrated better specificity than CA 125 in benign gynecologic disease patients, with abnormal concentrations in 1.3% and 33.6% , respectively. A significantly higher area under the ROC curve was obtained with HE4 than with CA 125 in the differential diagnosis of gynecologic diseases (0.875 vs 0.723; p=0.0001). Both markers were clearly related to stage (HE4:p=0.004; CA-125: p=0.001).) and histopathological type (HE4: p =0.003 and CA-125:p =0.009 in serous papillary ovarian cancer). Conclusion: HE4 has significantly higher diagnostic specificity than CA 125, and the combination of CA-125 and HE4 improved the detection of ovarian cancer in all stages and histological types. HE4 use may be important in the differential diagnosis of ovarian cancer.


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