Comparison between Serum HE4 and CA125 as Tumor Markers in Premenopausal Women with Benign Pelvic Mass

Huang X, Xiaoli Huang, Wang Y, Yanlong Wang, Xiaoqin He, He X, Fenhong Kang, Kang F, Luo L, Linhua Luo, Zhiying Su, Su Z, Ye H, Huiming Ye
Clinical laboratory · 2019 · vol. 65(05/2019) · doi:10.7754/clin.lab.2018.180913 · PMID:31115211 · W2946778205
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This study found that serum HE4 is a more specific tumor marker than CA125 for diagnosing benign pelvic masses in premenopausal women, showing fewer false positives, particularly in cases of endometriosis.

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This study evaluated the diagnostic utility of serum HE4 and CA125 levels, along with the ROMA score, in distinguishing benign pelvic masses from healthy controls among premenopausal women. The researchers analyzed data from 391 patients with benign masses and 45 healthy individuals, finding that CA125 was elevated in 37.1% of cases compared to only 2.3% for HE4. The authors noted that endometriosis caused false-positive results for CA125 in more than half of the affected cases, whereas HE4 levels remained largely unaffected by this condition. Consequently, the paper concludes that HE4 offers higher specificity than CA125 for diagnosing benign pelvic masses in this demographic. Relevance to endometriosis: listed as a cause of false-positive CA125 results, though the paper's main focus is differentiating benign ovarian masses from malignancy.

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Abstract

BACKGROUND: The aim of the study was to evaluate the role of human epididymal secretory protein (HE4), cancer antigen 125 (CA125), and the Risk of Ovarian Malignancy Algorithm (ROMA) in diagnosing benign pelvic masses in premenopausal women. METHODS: Serum was collected from 391 premenopausal women with benign pelvic mass prior to surgery and from 45 healthy individuals. Serum HE4 and CA125 levels and ROMA scores were evaluated separately. RESULTS: Among the 391 women with benign pelvic mass, 2.3% (9/391) had elevated HE4 levels (> 70 pmol/L), while 37.1% (145/391) had elevated CA125 levels (> 35 U/mL) (p < 0001). Endometriosis provided false-positive results for CA125 levels in more than half of the cases but resulted in no significant change for HE4 level. In 13 gravid women with a mass, 30.8% (4/13) and 38.5% (5/13) had elevated HE4 and CA125 levels, respectively; however, the difference was not significant (p > 0.05). Moreover, serum levels and patient percentages for CA125 elevation significantly increased with increase in mass diameter, whereas those for HE4 did not. CONCLUSIONS: CA125 elevation showed random results for benign pelvic masses, while HE4 elevation showed a higher specificity. Thus, serum HE4 testing is a better approach than CA125 testing for diagnosing benign pelvic masses in premenopausal women.
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Background

The aim of the study was to evaluate the role of human epididymal secretory protein (HE4), cancer antigen 125 (CA125), and the Risk of Ovarian Malignancy Algorithm (ROMA) in diagnosing benign pelvic masses in premenopausal women.

Methods

Serum was collected from 391 premenopausal women with benign pelvic mass prior to surgery and from 45 healthy individuals. Serum HE4 and CA125 levels and ROMA scores were evaluated separately.

Results

Among the 391 women with benign pelvic mass, 2.3% (9/391) had elevated HE4 levels (> 70 pmol/L), while 37.1% (145/391) had elevated CA125 levels (> 35 U/mL) (p < 0001). Endometriosis provided false-positive results for CA125 levels in more than half of the cases but resulted in no significant change for HE4 level. In 13 gravid women with a mass, 30.8% (4/13) and 38.5% (5/13) had elevated HE4 and CA125 levels, respectively; however, the difference was not significant (p > 0.05). Moreover, serum levels and patient percentages for CA125 elevation significantly increased with increase in mass diameter, whereas those for HE4 did not.

Conclusions

CA125 elevation showed random results for benign pelvic masses, while HE4 elevation showed a higher specificity. Thus, serum HE4 testing is a better approach than CA125 testing for diagnosing benign pelvic masses in premenopausal women. DOI: 10.7754/Clin.Lab.2018.180913 |

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Condition tags

endometriosis

MeSH descriptors

Biomarkers, Tumor CA-125 Antigen Endometriosis Membrane Proteins Ovarian Neoplasms Premenopause Proteins Adolescent Adolescent Adult Adult Biomarkers, Tumor Biomarkers, Tumor CA-125 Antigen CA-125 Antigen Diagnosis, Differential Diagnosis, Differential Endometriosis Endometriosis Endometriosis

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