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Gynecol Oncol. 2015 Jun;137(3):430-5. doi: 10.1016/j.ygyno.2015.03.044. Epub 2015 Apr 9.

Detection of the HE4 protein in urine as a biomarker for ovarian neoplasms: Clinical correlates.

Author information

1
Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, WA 98195, USA.
2
Department of Pathology, University of Washington School of Medicine, Seattle, WA 98195, USA.
3
Department of Pathology, University of Washington School of Medicine, Seattle, WA 98195, USA. Electronic address: ihellstr@u.washington.edu.

Abstract

OBJECTIVES:

To measure HE4 levels in urine from normal donors, patients with LMP tumors and ovarian cancer patients and to correlate levels with clinical factors in ovarian cancer patients.

METHODS:

Archived samples from controls, patients with LMP tumors and ovarian cancer were tested using commercial assays, including serially collected serum and urine samples from women treated for stage III/IV serous ovarian cancer.

RESULTS:

Five of 6 patients with stage I/II and 26 of 36 stage III/IV serous ovarian cancer patients had HE4-positive urines, similar to serum samples (4 of 5 stage I/II and 26 of 34 stage III/IV) when tested at the same level of specificity (95%). Urine HE4 was more sensitive in LMP tumors: 9 of 32 urines (28%) HE4-positive versus 3 of 68 sera (4.4%, p=0.002). Mean levels of serum CA125 and HE4 decreased comparably in patients during initial treatment regardless of their primary platinum response, but mean urine HE4 levels decreased only 7% in primary platinum resistant patients while decreasing 68% in those who were sensitive. By 7months after diagnosis, urine HE4 levels were higher in primary platinum resistant patients compared to those who proved to be sensitive (p=0.051) and persisted 12months after diagnosis (p=0.014). HE4 values in urine also became positive in advance of clinical recurrence in several women while serum HE4 and serum CA-125 remained normal.

CONCLUSIONS:

Measuring HE4 in urine complements serum assays for the detection of ovarian cancer and may allow identification of patients at high risk for primary platinum resistance.

KEYWORDS:

ELISA; HE4; LMP; Ovarian cancer; Urine

PMID:
25866324
PMCID:
PMC4447602
DOI:
10.1016/j.ygyno.2015.03.044
[Indexed for MEDLINE]
Free PMC Article

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