Utility Serum Marker HE4 for the Differential Diagnosis Between Endometriosis and Adnexal Malignancy

Ignacio Zapardiel, Mikel Gorostidi, Antonella Ravaggi, Allende MT, Maria T Allende, M.T. Allende, Silveira M, Margarida Silveira, Daniel Abehsera, Abehsera D, Macuks R, Ronalds Macuks, Ronalds Mačuks
International journal of gynecological cancer : official journal of the International Gynecological Cancer Society · 2015 · vol. 26(1) , pp. 52–55 · doi:10.1097/igc.0000000000000579 · PMID:26512790 · W2335749471
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This study evaluated the utility of the serum marker HE4 in distinguishing endometriosis from adnexal malignancies.

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Abstract

ObjectiveThe aim of the study was to assess the utility of serum human epididymal secretory protein E4 (HE4) biomarker in the differential diagnosis of endometriosis and adnexal malignancies.MethodsMulticentric prospective observational study between January 2010 and December 2011 in 4 European centers (Italy, Portugal, Latvia, and Spain) was carried out. We collected 981 healthy patients diagnosed with adnexal patology and selected 65 patients diagnosed with endometriosis and analyzed their serum markers CA125, HE4, and Risk of Ovarian Malignancy Algorithm (ROMA) index. We also analyzed all cases of malignant histology and divided them according to CA125 levels (negative, ≤35 U/mL; intermediate, >35-150 U/mL; and highly positive, >150 U/mL).ResultsHE4 was positive only in 1.5% of cases, CA125 in 64.6%, and ROMA index in 14.1%. In the subgroup intermediate CA125 values, positive HE4 is very specific (91.2%) correctly classifying patients with benign disease, but with lower sensibility (66.1%); however, ROMA index showed a high sensibility (89.3%), with a false-positive rate of 42.8%.ConclusionsHE4 can be a very useful biomarker to exclude malignant disease in patients with endometriosis.

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Condition tags

endometriosis

MeSH descriptors

Adnexal Diseases Biomarkers Biomarkers, Tumor Endometriosis Proteins Adnexal Diseases Adnexal Diseases Biomarkers Biomarkers, Tumor Case-Control Studies Diagnosis, Differential Endometriosis Endometriosis Female Follow-Up Studies Humans Middle Aged Prognosis Prospective Studies Proteins

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