Prognostic significance of human epididymis protein 4 in epithelial ovarian cancer

Eur J Obstet Gynecol Reprod Biol. 2011 Oct;158(2):338-42. doi: 10.1016/j.ejogrb.2011.05.021. Epub 2011 Jun 17.

Abstract

Objective: The purpose of this study was to evaluate the prognostic significance of serum human epididymis protein 4 (HE4) level in patients with epithelial ovarian cancer.

Study design: A total of 78 women diagnosed with a pelvic mass and operated on in our institute comprised our cohort. Forty-five of these were diagnosed with epithelial ovarian cancer and treated with debulking surgery, followed by taxane and platinum-based chemotherapy as clinically indicated. Preoperatively obtained serum samples were analyzed for levels of HE4 and CA125.

Results: The elevated serum HE4 level was related to advanced stage and serous type of cancer. The median duration of the follow-up was 35.1 months. In advanced stage, the median progression-free survival (PFS) of patients with elevated serum HE4 levels was 20.1 months (95% CI, 15.7-24.6 months), whereas that of patients with normal serum HE4 level was 24.2 months (95% CI, 13.9-34.6 months) (p=0.029). Independent predictors for PFS in patients with advanced stage EOC included serum HE4 level (hazard ratio 2.24; 95% CI, 1.14 to 6.84; p=0.048).

Conclusions: Our results demonstrated that an elevated serum HE4 level was related to the advanced stage of epithelial ovarian cancer. An elevated serum level of HE4 is a poor prognostic factor for PFS in patients with epithelial ovarian cancer who were treated with debulking surgery and adjuvant taxane and platinum-based chemotherapy. The serum HE4 level is a promising indicator for the progression of cancer as well as a biomarker for the detection of epithelial ovarian cancer.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biomarkers, Tumor / blood*
  • CA-125 Antigen / blood
  • Carcinoma, Ovarian Epithelial
  • Disease Progression
  • Female
  • Humans
  • Middle Aged
  • Neoplasm Staging
  • Neoplasms, Glandular and Epithelial / blood*
  • Neoplasms, Glandular and Epithelial / pathology
  • Neoplasms, Glandular and Epithelial / therapy
  • Ovarian Neoplasms / blood*
  • Ovarian Neoplasms / pathology
  • Ovarian Neoplasms / therapy
  • Predictive Value of Tests
  • Prognosis
  • Proteins / analysis*
  • WAP Four-Disulfide Core Domain Protein 2

Substances

  • Biomarkers, Tumor
  • CA-125 Antigen
  • Proteins
  • WAP Four-Disulfide Core Domain Protein 2
  • WFDC2 protein, human