Human epididymis protein 4 (HE4) in benign and malignant diseases
Abstract
Background: Human epididymis protein 4 (HE4) is described as a useful new biomarker in ovarian cancer. As HE4 is neither tumor nor organ specific, we intensively investigated the occurrence of this protein in female and male patients with various benign and malignant diseases in order to avoid misinterpretation and to identify potential additional clinical relevance. Methods: We retrospectively investigated HE4 (ARCHITECT ® , Abbott Diagnostics, US) in the sera of 205 healthy individuals, 654 patients with benign disorders and 720 patients with cancer before initial treatment. Results: The lowest concentrations of HE4 were observed in healthy men (median 26.2 pmol/L) followed by healthy women (median 40.4 pmol/L). In benign diseases, highest HE4 concentrations were seen in both women and men with renal failure (women, median 1041 pmol/L; men, median 1368 pmol/L). In women, the highest HE4 levels in malignant diseases were observed in ovarian cancer (median 242 pmol/l), whereas the highest HE4 concentrations in men occurred in lung cancer (median 89.2 pmol/L). The area under the curve (AUC) of HE4 in women was highest in ovarian cancer and borderline tumors as compared to benign gynecological disorders (88.9%), with a sensitivity of 67.4% at 95% specificity. Also, significantly elevated concentrations of HE4 with reference to the respective group of benign diseases were observed in uterus corpus and breast cancer as well as in lung cancer for men and women. Conclusions: HE4 has the highest relevance in ovarian cancer but can be elevated in a variety of benign and malignant diseases.
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Serum biomarkers are often insufficiently sensitive or specific to facilitate cancer screening or diagnostic testing.
“Serum biomarkers are often insufficiently sensitive or specific to facilitate cancer screening or diagnostic testing.”
From Detection of ovarian cancer via the spectral fingerprinting of quantum-defect-modified carbon nanotubes in serum by machine learning (2022) · cites this paper as [7]
Stand-alone serum biomarker measurements have proven of little survival benefit due to limited specificity and low positive predictive value.
“However, stand-alone biomarker measurements have proven of little survival benefit due to limited specificity and low positive predictive value (PPV)7,8.”
From Detection of ovarian cancer via the spectral fingerprinting of quantum-defect-modified carbon nanotubes in serum by machine learning (2022) · cites this paper as [7]
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- Authors
- Hertlein, L., Stieber, P., Kirschenhofer, A., Fürst, S., Mayr, D., Hofmann, K., Krocker, K., Nagel, D., Lenhard, M., & Burges, A.
- Affiliations
- Ludwig-Maximilians-Universität München (DE)
- Corresponding author
- Hertlein, Linda
- Venue
- Clinical Chemistry and Laboratory Medicine (CCLM)
- Publisher
- Walter de Gruyter GmbH
- Published
- 2012-07-24
- Volume
- 50
- Issue
- 12
- Pages
- 2181-2188
- ISSN
- 1434-6621 (ISSN-L)
- 1437-4331
- OpenAlex
- W1999217676
- Cited by
- 100
- References
- 22
- Citations by year
- 2026: 7 · 2025: 9 · 2024: 7 · 2023: 8 · 2022: 6 · 2021: 9 · 2020: 7 · 2019: 5 · 2018: 4 · 2017: 7 · 2016: 8 · 2015: 11 · 2014: 7 · 2013: 3 · 2012: 2
- FWCI
- 8.57
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Chemistry and Laboratory Medicine (CCLM) (publishedVersion)
- PubMed (publishedVersion)
- Open access LMU (Ludwid Maxmilian's Universitat Munchen) (submittedVersion)
- Funders
- Abbott Diagnostics
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian cancer diagnosis and treatment
- Health Sciences › Medicine › Oncology › Cancer Diagnosis and Treatment
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Keywords
- HE4, tumor markers, ovarian cancer, benign disease, renal failure, lung cancer, endometrial cancer, breast cancer, borderline ovarian tumors, serum protein levels, sensitivity and specificity
- MeSH terms
- WAP Four-Disulfide Core Domain Protein 2, Adult, Aged, Female, Humans, Lung Neoplasms, Male, Middle Aged, Ovarian Neoplasms, Proteins, Retrospective Studies, Biomarkers, Tumor, Case-Control Studies
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