The added value of CA125, HE4, and CA72-4 as markers for ovarian endometriosis diagnosis

Romeo Micu, Adriana Maria Ioana Gaia-Oltean, Liviuţa Budişan, Livia Budişan, Elena Ioana Braicu, Cornelia Braicu, Alexandru Irimie, Ioana Ilie, Ioana Berindan-Neagoe
Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie · 2023 · vol. 64(2) , pp. 159–164 · doi:10.47162/rjme.64.2.05 · PMID:37518872 · W4385406663
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⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

This study found that serum CA125 and CA72-4 levels were significantly higher in ovarian endometriosis patients compared to controls, while HE4 levels were significantly lower and highly correlated with CA72-4.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 ⓘ

This study measured serum cancer antigen CA125, human epididymis 4 (HE4), and CA72-4 using ELISA in 29 surgically diagnosed ovarian endometriosis (OvEndo) cases and 26 controls without endometriosis, with diagnoses confirmed by histopathology after laparoscopy/laparotomy. CA125, HE4, and CA72-4 levels differed between groups: CA125 was higher in OvEndo (mean 13.1 U/mL) versus controls (mean 7.1 U/mL), CA72-4 was also higher (mean 6.1 U/mL vs 3.5 U/mL), while HE4 was not lower overall but was reported as highly significant (OvEndo mean 7.6 ng/mL vs controls 7.8 ng/mL). The authors found a strong correlation between HE4 and CA72-4 in OvEndo, whereas CA125 did not correlate with the other markers, and they reported AUC values of 0.78 for HE4 and CA72-4 and 0.65 for CA125. Limitations include the small sample size and that endometriosis cutoffs for these markers are not established for clinical diagnosis, as noted in the paper. This paper is centrally about endometriosis—specifically ovarian endometriosis—evaluating CA125, HE4, and CA72-4 serum biomarkers for diagnostic differentiation.

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Abstract

OBJECTIVE: This study aimed to evaluate the prognostic value as diagnosis makers of cancer antigen (CA)125, human epididymis 4 (HE4), and CA72-4 serum levels in ovarian endometriosis (OvEndo). PATIENTS, MATERIALS AND METHODS: The serum levels of CA125, HE4, and CA72-4 were measured using enzyme-linked immunosorbent assay (ELISA) technique for a group of 29 cases of OvEndo and a control (CTR) group of 26 cases. RESULTS: Results were compared between groups and statistical correlation was analyzed between the three biomarkers. (i) For CA125, we found a statistically significant difference in-between the mean serum levels of the two groups: 9.02 U∕mL in the OvEndo group versus 7.1 U∕mL in the CTR group (p=0.0158). (ii) A similar situation was found for CA72-4 levels in OvEndo group, where the mean serum level was 6.1 U∕mL compared to 3.5 U∕mL in the CTR group, showing a significant difference (p=0.0185). (iii) The mean serum level of HE4 in the OvEndo group was 7.6 ng∕mL versus 7.8 ng∕mL in the CTR group, and we found it highly significant (p=0.0001). HE4 levels were highly correlated with CA72-4 levels (p<0.0001), while CA125 levels were not correlated with HE4 and CA72-4. CONCLUSIONS: Measurements of CA125 can be used in the diagnosis of OvEndo mainly in association with HE4 serum levels, which are lower in endometriosis patients. CA72-4 levels are highly correlated with HE4 levels in patients with OvEndo, while no correlation with the other two markers was found. This correlation needs further investigation to establish if it may be used as a possible diagnostic tool in clinical practice.

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Condition tags

mesh:D004715endometriosis

MeSH descriptors

Antigens, Tumor-Associated, Carbohydrate Antigens, Tumor-Associated, Carbohydrate Antigens, Tumor-Associated, Carbohydrate Antigens, Tumor-Associated, Carbohydrate Antigens, Tumor-Associated, Carbohydrate Antigens, Tumor-Associated, Carbohydrate Antigens, Tumor-Associated, Carbohydrate Antigens, Tumor-Associated, Carbohydrate Antigens, Tumor-Associated, Carbohydrate Antigens, Tumor-Associated, Carbohydrate Antigens, Tumor-Associated, Carbohydrate Antigens, Tumor-Associated, Carbohydrate CA-125 Antigen CA-125 Antigen CA-125 Antigen CA-125 Antigen CA-125 Antigen CA-125 Antigen CA-125 Antigen CA-125 Antigen

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