The Utility of Human Epididymal Protein 4, Cancer Antigen 125, and Risk for Malignancy Algorithm in Ovarian Cancer and Endometriosis

Kadija, Saša; Stefanović, Aleksandar; Jeremić, K.; Radojević, Miloš M.; Nikolić, Ljubinka I.; Marković, Ivanka; Atanacković, Jasmina

doi:10.1097/igc.0b013e318234f852

Cited by 48 publications

(36 citation statements)

References 20 publications

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“…Overall, ultrasound diagnosis of ovarian masses with increased HE4 and CA-125 suggests the presence of ovarian cancer; if only increased CA-125 is observed, the patient may have ovarian endometriosis or other benign diseases; if only increased HE4 is observed, the patient may have ovarian or endometrial cancer or other malignant tumors. Consistent with results of Chinese and worldwide studies (Moore et al, 2011;Bandiera et al, 2011;Jacob et al, 2011;Lenhard et al, 2011;Montagnana et al, 2011;Van Gorp et al, 2011;Kadija et al, 2012), our retrospective analysis showed that HE4 can be used as a marker for the diagnosis of ovarian cancer and endometrial cancer, and is more effective than using CA-125.…”

Section: Comparison Of Ca-125 Among Groupssupporting

confidence: 78%

Increased human epididymis protein 4 in benign gynecological diseases complicated with chronic renal insufficiency patients

Yang

Zhang

et al. 2015

Genet. Mol. Res.

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ABSTRACT. We examined the serum concentration of human epididymis protein (HE4) in patients with benign gynecological diseases complicated with chronic renal deficiency and its significance in the differential diagnosis of benign and malignant gynecological diseases. Serum HE4 and cancer antigen 125 concentrations were detected by chemiluminescence. Clinically or pathologically confirmed gynecological diseases were grouped and retrospectively analyzed, including 50 cases of gynecological benign diseases, 35 cases of non-mucinous epithelial ovarian carcinoma, 36 cases of endometrial adenocarcinoma, 15 cases of gynecological benign diseases patients complicated with chronic renal deficiency, 15 cases of gynecological diseases without chronic renal deficiency, and 30 normal controls. Serum HE4 values in the ovarian cancer group, endometrial cancer group, gynecological benign diseases with chronic renal deficiency group, and chronic renal deficiency group were significantly increased compared with the benign gynecological diseases and normal control groups, showing a significant difference (P < 0.001). A comparison of 4 groups with high HE4 showed that the HE4 level in the 2 groups 2157 HE4 in benign gynecology with renal insufficiency ©FUNPEC-RP www.funpecrp.com.br Genetics and Molecular Research 14 (1): 2156-2161 (2015) with renal deficiency were higher than those in the ovarian cancer and endometrial cancer groups, but the difference was not significant (P > 0.05); there was no significant difference between 2 groups with renal deficiency (P > 0.05). Serum concentration of HE4 was high in patients with chronic renal deficiency, which should be distinguished during differential diagnosis of gynecological benign and malignant tumors in patients with chronic renal deficiency to avoid misdiagnosis.

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Section: Comparison Of Ca-125 Among Groupssupporting

confidence: 78%

Increased human epididymis protein 4 in benign gynecological diseases complicated with chronic renal insufficiency patients

Yang

Zhang

et al. 2015

Genet. Mol. Res.

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“…Thus, the overall view is that for women who are not at clearly high risk for ovarian cancer, the "harms" of routine screening for ovarian cancer outweigh the benefits [16]. Although the possibility of employing biomarkers other than CA-125 has been examined [17][18][19][20][21], none of these appear to sufficiently improve diagnostic accuracy to recommend their use for routine ovarian cancer screening [22].…”

Section: The Clinical Problem: the Need For Accurate And Timely Detecmentioning

confidence: 99%

Synergism of spectra averaging and extrapolation for quantification of in vivo MRS time signals encoded from the ovary

Belkić

2017

J Math Chem

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The fast Padé transform (FPT) is further optimized for encoded in vivo MRS time signals. This is achieved by a judicious combination of spectra averaging and time signal extrapolation. The motivation is in strengthening suppression of the over-sensitivity of signal processing to changes in model order K . Implementation is carried out in the FPT variant FPT (+) which, by numerically performed analytical continuation, converts divergent into convergent series. Convergence of reconstructions is monitored for a sequence of successive values of K . Comparison is made with the corresponding retrieval without spectra averaging and time signal extrapolation. Variances are dramatically reduced for the reconstructed parameters (complex frequencies and complex amplitudes) when spectra averaging and extrapolation are performed. Negligible variances imply convergence, which is accomplished herein using a single averaging procedure (no iterations). This has important implications in practice with encoded MRS data, providing remarkable efficiency, robustness and accuracy of Padé-based quantification. Algorithmically, spectra averaging and time signal extrapolation consist of four steps. First, the encoded time signal is used to compute total shape spectra (envelopes) for a sequence of model orders K , which is the number of resonances. Second, these envelopes are averaged (spectra averaging). All the spectra are computed at the same sweep frequencies whose number considerably exceeds the number of data points in the encoded time signal. Third, the complex average envelope is inverted to yield a new time signal which is longer than the encoded data (time signal extrapolation). Fourth, the Padé extrapolated time signal is quantified for a sequence of K to monitor convergence of the reconstructed parameters. All four steps are applied to in vivo MRS data encoded on a 3 T scanner from a borderline serous cystic ovarian tumor. We focus on this clinical problem to help develop effective methods for early detection of ovarian cancer, in order to improve survival for women afflicted with this malignancy. It is anticipated that the presently refined, multi-purpose Padé-based methodology with its practical advantages for in vivo MRS can contribute to this goal.

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“…Currently, several trials are under way using test kits from various manufacturers [13,14,16,19,21,22]. The strategy with ROMA, as well as normal ranges, cutoff points, and interpretation await further optimization.…”

Section: Introductionmentioning

confidence: 99%

“…Modern imaging techniques and fast progress in laboratory tests have enabled a great step forward in diagnostic algorithms [4][5][6][7][8][9][10][11]. ROMA (Risk of Malignancy Algorithm) based on CA125 and the novel HE4 marker has recently emerged as a promising approach to the preoperative categorization of malignancy risk [12][13][14][15][16][17][18][19][20][21][22]. HE 4 is new marker which was recently proposed for ovarian cancer because of its specificity and high expression in ovarian cancer tissues [23][24][25][26][27][28].…”

Section: Introductionmentioning

confidence: 99%

Preoperative Diagnostic Performance of ROMA (Risk of Ovarian Malignancy Algorithm) in Relation to Etiopathogenesis of Epithelial Ovarian Tumors

Chudecka‐Głaz¹,

Cymbaluk‐Płoska²,

Menkiszak³

et al. 2013

J Mol Biomark Diagn

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Chudecka-Glaz et al., J Mol Biomark Diagn 2013, S4 http://dx.doi.org/10.4172/2155-9929.S4-003 IntroductionThousands of patients with ovarian tumor or cyst are hospitalized and operated all over the world. According to the National Cancer Institute, USA, 13-21% of women are diagnosed with ovarian cancer (EOC) at various clinical stages [1]. Stratification of pelvic mass cases to high-and low-risk groups is important for several reasons. Firstly, recent research has shown that ovarian cancer patients operated at centers specializing in female malignancies have a greater chance of survival [2]. Secondly, the therapeutic decision in cases of ovarian/ adnexal tumor relies heavily on the correct diagnostication. Whether the tumor is malignant or benign, the surgeon will choose between laparoscopy or laparotomy, abdominal access (midline or transverse), and extent of surgery. Optimal operative cytoreduction by a skilled surgeon combined with correct staging according to FIGO greatly improves distant results of management in ovarian cancer [3]. Modern imaging techniques and fast progress in laboratory tests have enabled a great step forward in diagnostic algorithms [4][5][6][7][8][9][10][11]. ROMA (Risk of Malignancy Algorithm) based on CA125 and the novel HE4 marker has recently emerged as a promising approach to the preoperative categorization of malignancy risk [12][13][14][15][16][17][18][19][20][21][22]. HE 4 is new marker which was recently proposed for ovarian cancer because of its specificity and high expression in ovarian cancer tissues [23][24][25][26][27][28]. The diagnostic performance of ROMA was advocated for the first time by Moore et al. [15] who demonstrated that CA125 combined with HE4 reveals the highest sensitivity and specificity among nine markers studied.FDA now recommends ROMA in women over 18 years of age with a pelvic tumor or cyst qualified for surgery, emphasizing that ROMA must always be interpreted against clinical and radiology findings [29]. Currently, several trials are under way using test kits from various manufacturers [13,14,16,19,21,22]. The strategy with ROMA, as well as normal ranges, cutoff points, and interpretation await further optimization.This work was undertaken to determine the diagnostic performance of ROMA for preoperative stratification of patients with a pelvic mass using cutoff points determined by us and adopt from literature. Additionally we studied usefulness of ROMA algorithm due to recent concepts of etiology of epithelial ovarian malignancies and their categorization to type I and II. We also evaluated the Elecsys HE4

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The Utility of Human Epididymal Protein 4, Cancer Antigen 125, and Risk for Malignancy Algorithm in Ovarian Cancer and Endometriosis

Abstract: HE4 showed satisfactory capability of distinguishing endometriosis from ovarian cancer, which CA125 lacked. The Risk of Ovarian Malignancy Algorithm score proved to be useful in excluding malignant diagnosis in premenopausal women.

Cited by 48 publications

References 20 publications

Increased human epididymis protein 4 in benign gynecological diseases complicated with chronic renal insufficiency patients

Increased human epididymis protein 4 in benign gynecological diseases complicated with chronic renal insufficiency patients

Synergism of spectra averaging and extrapolation for quantification of in vivo MRS time signals encoded from the ovary

Preoperative Diagnostic Performance of ROMA (Risk of Ovarian Malignancy Algorithm) in Relation to Etiopathogenesis of Epithelial Ovarian Tumors

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