Diagnostic performances of HE4 and CA125 for the detection of ovarian cancer from patients with various gynecologic and non-gynecologic diseases

Clin Biochem. 2011 Jul;44(10-11):884-8. doi: 10.1016/j.clinbiochem.2011.04.011. Epub 2011 Apr 22.


Objectives: We compared diagnostic performance of CA125 and HE4 in various gynecologic and non-gynecologic diseases.

Design and methods: Sera from 176 patients with various diseases were collected, and CA125 and HE4 levels were compared. ROC curves were constructed to estimate the diagnostic performance.

Results: Levels of both markers were elevated in ovarian cancer. CA125 was also high in benign gynecologic diseases, but HE4 was not. CA125 levels of pregnant women were higher than those of control group, and HE4 was increased in chronic renal diseases. The sensitivity for discriminating ovarian cancer from healthy or benign conditions was 44.8% for HE4 and 55.2% for CA125 at 95% specificity. The ROC-AUC values for HE4 and CA125 were 0.85 and 0.87 respectively.

Conclusions: HE4 demonstrated comparable diagnostic performances to CA125, though each marker had its own strengths and weaknesses. Combining CA125 and HE4 might be more advantageous than either one alone.

MeSH terms

  • CA-125 Antigen / blood*
  • Diagnosis, Differential
  • Epididymal Secretory Proteins* / metabolism
  • Female
  • Humans
  • Ovarian Neoplasms / blood*
  • Ovarian Neoplasms / diagnosis*
  • ROC Curve
  • beta-Defensins


  • CA-125 Antigen
  • DEFB126 protein, human
  • Epididymal Secretory Proteins
  • beta-Defensins