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15.02.2024 | Original Article

Predictive Role of HE4 in Diagnosis of Ovarian Tumors

verfasst von: Satya Kumari, Pratibha Kumari, Sangeeta Pankaj, Jyotsna Rani, Kavya Abhilashi, Vijayanand Choudhary, Jaya Kumari

Erschienen in: The Journal of Obstetrics and Gynecology of India

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Abstract

Background

Approximately 20% of women develop an ovarian cyst or pelvic mass at some point in their lives. Due to high false positivity of CA-125, women with various benign ovarian tumors simulating malignant masses undergo extensive debulking surgery resulting in increased morbidity. Serum HE4 is a useful test for better discrimination of benign or malignant nature of pelvic masses in preoperative period. Our study gives an update on the biological markers specifically CA-125 and a novel tumor marker HE4 and aims to reduce the debulking surgeries done for benign pathology.

Materials and Methods

The total study population (n = 302) included women who were operated with suspicious ovarian malignant mass (n = 238) with benign (n = 98), borderline (n = 6), and malignant (n = 134) ovarian tumors. Cutoff of CA-125 was 35 U/mL, and for HE4 140 pM for postmenopausal and 70 pM for premenopausal women were calculated at 86% and 81% accuracy, respectively. Statistical analysis was done using SPSS version 20.

Results

The cutoff values of CA-125 were able to differentiate between benign, borderline, and malignant tumors with statistical significance (p < 0.05), whereas the cutoff values of HE4 significantly (p < 0.05) differentiated benign tumors from the malignant tumors, but not from the borderline tumors. Serum CA-125 has significantly higher sensitivity and NPV (95%, 72%, respectively) compared to HE4 (81%, 52%) and combined HE4 plus CA-125 (84%, 59%), whereas specificity, PPV, and AUC were higher for combined CA-125 plus HE4 (93%, 98%, 90%, respectively) compared to HE4 (83%, 95%, 88%) and CA-125 (48%, 88%, 87%).

Conclusion

Measuring serum HE4 along with CA-125 in preoperative diagnosis helps in excluding benign ovarian tumors in which CA-125 was falsely raised, especially in center where frozen section is not available, thus potentially decreasing morbid debulking surgeries done for benign ovarian tumors.
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Metadaten
Titel
Predictive Role of HE4 in Diagnosis of Ovarian Tumors
verfasst von
Satya Kumari
Pratibha Kumari
Sangeeta Pankaj
Jyotsna Rani
Kavya Abhilashi
Vijayanand Choudhary
Jaya Kumari
Publikationsdatum
15.02.2024
Verlag
Springer India
Erschienen in
The Journal of Obstetrics and Gynecology of India
Print ISSN: 0971-9202
Elektronische ISSN: 0975-6434
DOI
https://doi.org/10.1007/s13224-023-01936-8

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