Human epididymis protein 4 (HE4) in laboratory medicine and an algorithm in renal disorders

Kappelmayer, János; Antal‐Szalmás, Péter; Nagy, Béla

doi:10.1016/j.cca.2014.07.040

Cited by 27 publications

(34 citation statements)

References 79 publications

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“…The average HE4 level was 29% higher in smokers than that in nonsmokers [35,41]. Moreover, smoking may elevate HE4 levels to a larger extent in younger individuals than in elderly individuals with higher baseline values [39]. The mechanism underlying the elevated HE4 levels in individuals with high BMI or smoking habit is unknown although metabolism changes with BMI and airway expression of HE4/airway inflammatory response in smokers may be involved.…”

Section: Variation Of He4 Levels With Demographic Factorsmentioning

confidence: 96%

Physiopathological factors affecting the diagnostic value of serum HE4-test for gynecologic malignancies

Duan

et al. 2016

Expert Review of Molecular Diagnostics

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Section: Variation Of He4 Levels With Demographic Factorsmentioning

confidence: 96%

Physiopathological factors affecting the diagnostic value of serum HE4-test for gynecologic malignancies

Duan

et al. 2016

Expert Review of Molecular Diagnostics

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“…Over the past decade, HE4 has gained widespread use as an effective tumor marker in the diagnosis of OC. Numerous clinical studies have demonstrated significant elevations of serum HE4 levels in patients with gynecological cancer and have confirmed that HE4 levels may be used as a biomarker for OC with higher specificity than the widely used CA-125 (4,7,8,(10)(11)(12). A previous study observed that HE4 had sensitivity of 72.9% and specificity of 95% in the differential diagnosis of OC and benign ovarian masses (13).…”

Section: Introductionmentioning

confidence: 98%

“…Since the disease presents with non-specific symptoms, approximately 70% of patients with OC are not diagnosed until the disease has reached an advanced stage (3). Patients with high-grade OC often have poor prognosis and a high mortality rate (4). Therefore, early diagnosis of OC is a key factor in improving patient survival.…”

Section: Introductionmentioning

confidence: 99%

“…Although HE4 is a valuable marker in OC diagnosis, under certain circumstances, the evaluation of serum HE4 levels may be problematic when patients suffer from additional conditions (4). Abnormal HE4 concentrations are detected in certain nonmalignant diseases, causing difficulties in the differential diagnosis of OC.…”

Section: Introductionmentioning

confidence: 99%

“…These data indicate that serum HE4 concentrations may be affected by variable demographical factors or by non-malignant diseases. Thus, serum HE4 levels show a high false-positive rate in the differential diagnosis of OC, with the main factor being the presence of CKD (4). Recent studies have suggested that urine assays are a non-invasive alternative for the evaluation of HE4 levels.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic value of urinary-to-serum human epididymis protein 4 ratio in ovarian cancer

Fan

Luo

et al. 2017

Biomedical Reports

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Abstract. Human epididymis protein 4 (HE4) is one of the best-known tumor markers for ovarian cancer (OC). Emerging evidence indicates that the evaluation of serum HE4 (S-HE4) levels may be problematic when patients have chronic kidney disease (CKD). Assaying urine for HE4 levels is non-invasive alternative for the diagnosis of OC. However, whether the combined detection of S-and urinary HE4 (U-HE4) levels distinguishes OC from CKD remains unknown. To investigate this issue, the present study recruited 31 female patients with OC, 38 female patients with CKD, and 36 healthy control (HC) females. Serum and urine samples were preoperatively collected for HE4 level detection. Receiver operating characteristic (ROC) curves were constructed to assess the diagnostic performance of S-HE4 level, U-HE4 level and the ratio of urinary-to-serum HE4 level (R-HE4). Data from the current study indicated that serum HE4 levels in the OC and CKD groups were significantly higher than that in the HC group. The U-HE4 level in the OC group was significantly higher than that in the CKD and HC groups. The highest R-HE4 was observed in the HC group, followed by the OC group, and the lowest R-HE4 was observed in the CKD group. ROC analysis demonstrated that the R-HE4 was useful in differentiating OC from CKD and HC. Based on the diagnostic interval of optimal cut-off values from 36.85 to 96.15, the sensitivity and specificity of R-HE4 in differentiating OC patients from non-OC patients were 82.6 and 85.4%, respectively. Thus, the combined detection of S-and U-HE4 levels facilitates the diagnosis of OC, and R-HE4 is an effective marker for differentiating OC from CKD.

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Falsely elevated human epididymis protein 4 results and Risk of Ovarian Malignancy Algorithm in polymorbid women after solid organ transplantation: A pilot and case‐control study

Franeková

Cindr

Lavríková

et al. 2018

Clinical Laboratory Analysis

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Human epididymis protein 4 (HE4) in laboratory medicine and an algorithm in renal disorders

Cited by 27 publications

References 79 publications

Physiopathological factors affecting the diagnostic value of serum HE4-test for gynecologic malignancies

Physiopathological factors affecting the diagnostic value of serum HE4-test for gynecologic malignancies

Diagnostic value of urinary-to-serum human epididymis protein 4 ratio in ovarian cancer

Falsely elevated human epididymis protein 4 results and Risk of Ovarian Malignancy Algorithm in polymorbid women after solid organ transplantation: A pilot and case‐control study

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