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The differential diagnostic value and clinical significance of serum HE4 in ovarian disease with elevated CA125

Archives of Gynecology and Obstetrics volume 301, pages 1219–1225 (2020)Cite this article

Abstract

Objective

To determine the diagnostic value and clinical significance of serum HE4 levels in differentiating between benign and malignant ovarian disease in patients with elevated CA125 levels.

Methods

The levels and positive expression rate of HE4 were compared between 371 patients with elevated CA125 levels and benign ovarian disease, and 132 patients with epithelial ovarian cancer to determine the diagnostic value of HE4.

Results

The level and positive expression rate of HE4 differed significantly between the benign and malignant groups, in that, there was no significant difference in HE4 expression between CA125 low- and high-level groups within the benign ovarian disease group, with levels of HE4 being in the normal range in both groups. However, the positive expression rates and levels of HE4 in the malignant group were significantly different between the serum CA125 low- and high-level groups. ROC curve analysis showed that optimal HE4 cutoff values for increased accuracy in diagnosis were 78.03 pmol/L and 119.70 pmol/L before and after menopause, respectively.

Conclusions

Serum HE4 levels can potentially be used as a marker to differentiate between benign and malignant ovarian disease with elevated serum CA125 levels. The high specificity of HE4 was superior in identifying benign ovarian disease. We recommend increasing the cutoff values of HE4 in premenopausal patients and decreasing the cutoff values in postmenopausal patients for increased accuracy in the differential diagnosis of patients with elevated CA125 levels.

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Acknowledgements

The authors would like to thank all patients and participating hospitals.

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Affiliations

  1. Cancer Hospital of China Medical University, No. 44, Xiaohe Road, Dadong District, Shenyang, 110042, Liaoning, China

    Weishan Li & Danbo Wang

Authors
  1. Weishan Li
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  2. Danbo Wang
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by WL. The first draft of the manuscript was written by WL and was reviewed and edited by DW. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Danbo Wang.

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The authors declare no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Li, W., Wang, D. The differential diagnostic value and clinical significance of serum HE4 in ovarian disease with elevated CA125. Arch Gynecol Obstet 301, 1219–1225 (2020). https://doi.org/10.1007/s00404-020-05527-0

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  • DOI: https://doi.org/10.1007/s00404-020-05527-0

Keywords

  • HE4
  • CA125
  • Ovarian disease
  • Differential diagnosis