Usefulness of the Human Epididymis protein 4 (HE4) in the detection of ovarian cancer.

Abstract

Introduction: Although epithelial ovarian cancer (EOC) has a low prevalence, it is considered among the most lethal gynecological malignancies due to its high mortality. The interest in the early detection of ovarian cancer as a mechanism to achieve the reduction of mortality has grown with the discovery of serum tumor biomarkers associated with malignant tumors. The present study proposes to determine the efficacy of the use of the HE4 biomarker for the early detection of ovarian epithelial cancer in early stages.

Methods: We evaluated 53 patients with pelvic masses between April 2015 and March 2016. Sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratio, and statistical tests were calculated to determine the relationship between menopausal states, and groups according to the histological result (benign, malignant and control) of HE4, CA125 and ROMA.

Results: The human epididymal protein 4 - HE4 presented a differentiable mean value that allows to distinguish malignant pelvic masses (HE4: 7.19 (malignant) vs. 5.71 (benign)), likewise the combination HE4 + ROMA present greater sensitivity and specificity (S: 100%; E: 94.29 %) than combinations CA125 + HE4 and CA125 + ROMA (S: 80% and 88.89 %; E: 75.76 % and 77.14 %).

Conclusion: The results suggest that HE4 would serve as an efficient biomarker for the differentiation of pelvic masses in early stages and if menopausal status is added, and ROMA index would strengthen the results, allowing the differentiation of epithelial ovarian cancer in early stages in the country.