{"paper_id":"97817a40-b9e4-42b7-9af9-d0fd8ab3b3d5","body_text":"Letter to the Editor\nUsefulness of serum HE4 in endometriotic cysts\nM Montagnana *,1, G Lippi 1, E Danese 1, M Franchi 2 and GC Guidi 1\n1Dipartimento di Scienze Morfologico-Biomediche, Sezione di Chimica Clinica, Universita ` di Verona, Verona, Italy; 2Unita` di Ostetricia, Dipartimento\nMaterno ed Infantile, Universita` di Verona, Verona, Italy\nBritish Journal of Cancer (2009) 101, 548. doi:10.1038/sj.bjc.6605119 www.bjcancer.com\nPublished online 9 June 2009\n& 2009 Cancer Research UK\n/C12/C12/C12/C12/C12/C12/C12/C12/C12/C12/C12/C12/C12/C12/C12/C12/C12/C12/C12\nSir,\nHuhtinen et al (2009) recently reported about the usefulness\nof Human Epididymal Protein 4 (HE4) in discriminating\novarian tumours from ovarian endometriotic cysts, which is of\npivotal importance as CA125 is often increased in benign\ngynaecological diseases such as endometriosis (Muyldermans\net al , 1995). Therefore, we performed a similar study on 46\npatients affected by ovarian cancer and 21 patients affected by\nendometriosis (12 ovarian endometrioma and 9 non-ovaric\nendometriosis). Serum levels of CA125 were determined using a\nchemiluminescent enzyme immunoassay on the Liaison (DiaSorin,\nSaluggia, Italy). Serum levels of HE4 were determined using\nan ELISA kit developed by Fujirebio Diagnostic Inc. (Malvern, PA,\nUSA).\nThe mean serum concentration of HE4 in patients with ovarian\ncancer was significantly higher than that observed in patients with\nendometriosis (810.0 vs 49.4 pM, Po0.0001). The mean serum\nconcentrations of HE4 in our patients with ovarian endometrioma\nwere similar to those observed in the study of Huhtinen et al\n(2009) (47.5 vs 46.0 pM). However, in our investigation, 10 out of 12\npatients with ovarian endometrioma showed CA125 values higher\nthan 35 U ml /C01, but only one patient showed an HE4 serum\nconcentration higher than 70 p M, which is the upper limit of the\nreference range (Moore et al , 2008). More importantly, receiver\noperator characteristic curve analysis showed that HE4 has a\nsignificantly higher area under the curve as compared with CA125\n(0.85 vs 0.77, Po0.0001) for differentiating ovarian cancer from\novarian endometrioma. The results of our investigation confirm\nthat HE4 is a promising marker for the early differentiation of\novarian cancer from ovarian endometriotic cysts, showing better\ndiagnostic performances than CA125.\nConflict of interest\nThe authors declare no conflict of interest.\nREFERENCES\nHuhtinen K, Suvitie P, Hiissa J, Junnila J, Huvila J, Kujari H, Seta¨la¨ M, Ha¨rkki\nP, Jalkanen J, Fraser J, Ma¨kinen J, Auranen A, Poutanen M, Perheentupa A\n(2009) Serum HE4 concentration differentiates malignant ovarian tumours\nfrom ovarian endometriotic cysts. Br J Cancer 100(8): 1315 – 1319\nMuyldermans M, Cornillie FJ, Koninckx PR (1995) CA125 and endo-\nmetriosis. Hum Reprod Update 1: 173 – 187\nMoore RG, Brown AK, Miller MC, Skates S, Allard WJ, Verch T,\nSteinhoff M, Messerlian G, DiSilvestro P, Granai CO, Bast Jr RC (2008)\nThe use of multiple novel tumor biomarkers for the detection\nof ovarian carcinoma in patients with a pelvic mass. Gynecol Oncol\n108: 402 – 408\nPublished online 9 June 2009\n*Correspondence: Dr M Montagnana;\nE-mail: martina.montagnana@med.lu.se\nBritish Journal of Cancer (2009) 101, 548\n& 2009 Cancer Research UK All rights reserved 0007 – 0920/09 $32.00\nwww.bjcancer.com","source_license":"CC0","license_restricted":false}