Usefulness of HE4 protein in differentiation of pelvic masses in woman

Abstract

Introduction: HE4 protein (human epididymis protein-4), which is the fourth subfraction of human epithelial protein, is a glycoprotein widely used as a tumor marker in ovarian cancer. If was first discovered in the epididymal epithelium and recognized as a protease inhibitor contributing to sperm maturation. The plasma HE4 concentration may also be increased in gynecological pathologies other than ovarian cancer. Material and methods: The study was conducted between 2016 and 2017 among patients hospitalized in the Academic Department of Gynaecology. A total of 191 women were examined. Depending on the type of pathology which was the reason for hospitalization, 4 groups of patients were identified in the study. The first of these included 30 patients with ovarian cancer, the second 33 patients with benign ovarian lesion, the third 50 patients with endometrial cancer, and the fourth 28 patients with leiomyomas. Results: The highest concentration of HE4 protein was found in women with ovarian cancer, and it was statistically significantly higher compared to all other groups. Lower HE4 protein concentration than in women with ovarian cancer was reported in women with endometrial cancer, but it was statistically significantly higher compared to patients with uterine fibroids. Conclusions: This marker may have significant clinical value in the differentiation of benign ovarian pathology from ovarian cancer. The study confirms the validity of using HE4 results in the assessment of potential malignancy of ovarian and endometrial lesions.

Human epididymis protein 4 and Lewis y enhance chemotherapeutic resistance in epithelial ovarian cancer through the p38MAPK pathway

“…In 2008, the US Food and Drug Administration (FDA) identi ed HE4 as a serum marker for monitoring recurrence and progression in epithelial ovarian cancer (EOC) patients. Thereafter, HE4 started gradually stirring more and more attention; several studies have demonstrated the usefulness of HE4 in the early diagnosis of EOC and the identi cation of pelvic masses, especially when used in combination with the risk of ovarian malignancy algorithm (ROMA); moreover, HE4 exhibited higher sensitivity and speci city than its predecessors, including CA125 3,18 . In terms of function and mechanism, HE4 can promote the proliferation, invasion, metastasis, and drug resistance of ovarian cancer cells 10,19,20 .…”

Circulating non-coding RNAs in recurrent and metastatic ovarian cancer

“…The human epididymis protein-4 (HE4) encoded by the WAP four-disulfide core domain 2 gene is also a glycoprotein and commonly used as a tumor marker in OC. Its plasma levels are increased in gynecological pathologies and are useful in prognosis as well as in assessing the degree of differentiation and clinical progression of OC [40] . Dewan et al [41] compared the sensitivity and specificity of H4 values with those of CA125 using serum samples from OC patients and patients with benign ovarian diseases.…”

Gene Expression Profile of Active HE4 Stimulation in Epithelial Ovarian Cancer Cells: Microarray Study and Comprehensive Bioinformatics Analysis

“…Since then, more and more investigators are paying attention to it. Multiple studies found that HE4 is a useful biomarker possessing higher sensitivity and speci city than CA125 in the early con rmatory diagnosis for EOC and differentiation of pelvic masses, especially in combination with the risk of ovarian malignancy algorithm (ROMA) [12,13]; it seems to be a good predictive factor for the ideal tumor cytoreductive surgery [3], pre-operative prediction of residual disease after interval cytoreduction [4], adjuvant chemotherapy resistance [14] and the possibility of ascites formation [15].…”