A study published in December 2012 evaluated the relationship of preoperative HE4 with ovarian cancer survival. HE4 (Human Epididymis protein) is a blood test that appears to be elevated in patients with ovarian cancer - almost similar to CA125 blood test.
The study found that preoperative (before surgery) levels of HE4 were strongly associated with all ovarian cancer standard prognostic factors. HE4 levels increased significantly with age (p=0.02), cancer stage (p<0.0001), grade (p=0.005), preoperative CA-125 levels (p<0.0001), and residual tumor (p<0.0001). HE4 levels above the median value (394pmol/L) were significantly associated with mortality (HR=2.17; 95% CI: 1.42-3.32) and progression (HR=1.81; 95% CI: 1.21-2.72). After adjustment for the FIGO stage, which was the only factor significantly associated with prognosis in multivariate analyses, the association of HE4 with death remained statistically significant (HR=1.67; 95% CI: 1.08-2.59). However, the association with progression was no longer significant (HR=1.32; 95% CI: 0.87-1.99).
In English, the way I understood it, the high level of HE4 before surgery correlates with aggressiveness of ovarian cancer and the risk of death from this cancer. Thus, preoperative HE4 level may be used to discuss prognosis of the cancer. Do be careful since this study is based only on 136 patients. Usually, we want to see more studies before using this approach clinically.
Reference:
The study found that preoperative (before surgery) levels of HE4 were strongly associated with all ovarian cancer standard prognostic factors. HE4 levels increased significantly with age (p=0.02), cancer stage (p<0.0001), grade (p=0.005), preoperative CA-125 levels (p<0.0001), and residual tumor (p<0.0001). HE4 levels above the median value (394pmol/L) were significantly associated with mortality (HR=2.17; 95% CI: 1.42-3.32) and progression (HR=1.81; 95% CI: 1.21-2.72). After adjustment for the FIGO stage, which was the only factor significantly associated with prognosis in multivariate analyses, the association of HE4 with death remained statistically significant (HR=1.67; 95% CI: 1.08-2.59). However, the association with progression was no longer significant (HR=1.32; 95% CI: 0.87-1.99).
In English, the way I understood it, the high level of HE4 before surgery correlates with aggressiveness of ovarian cancer and the risk of death from this cancer. Thus, preoperative HE4 level may be used to discuss prognosis of the cancer. Do be careful since this study is based only on 136 patients. Usually, we want to see more studies before using this approach clinically.
Reference:
Trudel D, et al. Human
epididymis protein 4 (HE4) and ovarian cancer prognosis. Gynecol Oncol. 2012 Dec;127(3):511-5.
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