HE4 in the differential diagnosis of ovarian masses

Clin Chim Acta. 2015 Jun 15:446:147-55. doi: 10.1016/j.cca.2015.03.047. Epub 2015 Apr 16.

Abstract

Ovarian masses, a common finding among pre- and post-menopausal women, can be benign or malignant. Ovarian cancer is the leading cause of death from gynecologic malignancy among women living in industrialized countries. According to the current guidelines, measurement of CA125 tumor marker remains the gold standard in the management of ovarian cancer. Recently, HE4 has been proposed as emerging biomarker in the differential diagnosis of adnexal masses and in the early diagnosis of ovarian cancer. Discrimination of benign and malignant ovarian tumors is very important for correct patient referral to institutions specialized in care and management of ovarian cancer. Tumor markers CA125 and HE4 are currently incorporated into the "Risk of Ovarian Malignancy Algorithm" (ROMA) with menopausal status for discerning malignant from benign pelvic masses. The availability of a good biomarker such as HE4, closely associated with the differential and early diagnosis of ovarian cancer, could reduce medical costs related to more expensive diagnostic procedures. Finally, it is important to note that HE4 identifies platinum non-responders thus enabling a switch to second line chemotherapy and improved survival.

Keywords: CA125; Epithelial ovarian cancer; HE4; Ovarian mass; ROMA; Tumor markers.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Biomarkers, Tumor / blood
  • Biomarkers, Tumor / genetics*
  • CA-125 Antigen / blood
  • CA-125 Antigen / genetics*
  • Carcinoma, Ovarian Epithelial
  • Diagnosis, Differential
  • Female
  • Humans
  • Immunoassay
  • Neoplasms / blood
  • Neoplasms / diagnosis*
  • Neoplasms / genetics
  • Neoplasms / pathology
  • Neoplasms, Glandular and Epithelial / blood
  • Neoplasms, Glandular and Epithelial / diagnosis*
  • Neoplasms, Glandular and Epithelial / genetics
  • Neoplasms, Glandular and Epithelial / pathology
  • Ovarian Neoplasms / blood
  • Ovarian Neoplasms / diagnosis*
  • Ovarian Neoplasms / genetics
  • Ovarian Neoplasms / pathology
  • Postmenopause
  • Premenopause
  • Proteins / genetics*
  • Proteins / metabolism
  • Risk
  • Sensitivity and Specificity
  • WAP Four-Disulfide Core Domain Protein 2

Substances

  • Biomarkers, Tumor
  • CA-125 Antigen
  • Proteins
  • WAP Four-Disulfide Core Domain Protein 2
  • WFDC2 protein, human