HE4 might be a more useful tumor biomarker to detect malignancy in patients with ovarian endometrioma when malignancy is suspected

Mariona Rius, Pere Fusté, Cristina Ros, Ángeles Martínez-Zamora, Crístian de Guirior, Cristian deGuirior, Meritxell Gracia, Meritxell Gràcia, Eduard Mension, Eduard Mensión, Francisco Carmona
The Journal of international medical research · 2021 · vol. 49(9) , pp. 3000605211047701 · doi:10.1177/03000605211047701 · PMID:34590878 · PMC8489763 · W3201983268
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Abstract

OBJECTIVE: To analyze the utility of carbohydrate antigen (CA)125 and human epididymis protein 4 (HE4) to detect malignancy in women with ovarian endometriosis, when ovarian cancer is suspected and ultrasonography results are inconclusive. METHODS: Women who underwent surgery between 2015 and 2019 for ovarian endometriosis or for adnexal masses, with a final diagnosis of ovarian carcinoma (clear cell and endometrioid) were included in this retrospective study. The women were divided into three groups: ovarian endometriosis (OE), ovarian carcinoma without endometriosis (OC), and ovarian carcinoma with endometriosis (OC + E). Adnexal masses were assessed preoperatively by transvaginal ultrasonography according to the International Ovarian Tumor Analysis (IOTA) simple rules, and CA125 and HE4 blood levels were obtained. RESULTS: Of 208 women, 45 had malignancy, 16 in the OC + E group and 29 in the OC group. According to transvaginal ultrasonography, 13 were classified as undetermined risk of malignancy: OC group: 3, OE group: 3, and OC + E group: 7. When we compared the tumor biomarkers, significant differences in HE4 but not in CA125 levels were found between the groups. CONCLUSIONS: When ovarian malignancy is suspected in patients with ovarian endometriosis, HE4 is a more useful tumor biomarker to diagnose OC when ultrasonography results are inconclusive.

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Condition tags

endometriosisendometrioma

MeSH descriptors

Endometriosis Endometriosis Endometriosis Ovarian Neoplasms Ovarian Neoplasms Algorithms Biomarkers, Tumor CA-125 Antigen Carcinoma, Ovarian Epithelial Female Humans Retrospective Studies Sensitivity and Specificity WAP Four-Disulfide Core Domain Protein 2

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