What is HE4?
Human Epididymis Protein 4 (HE4) is a
biomarker commonly used in the field of gynecology for the detection and monitoring of ovarian cancer. It is a protein encoded by the
WFDC2 gene and is found in higher concentrations in the serum of patients with ovarian cancer compared to those with benign or normal conditions.
Why is HE4 Important in Gynecology?
HE4 is important because it offers several advantages over other biomarkers like
CA-125. It has a higher specificity for ovarian cancer, meaning it is less likely to produce false positives. This is particularly valuable for distinguishing between malignant and benign pelvic masses, thereby aiding in accurate diagnosis and appropriate treatment planning.
How is HE4 Used in Clinical Practice?
HE4 can be measured through a
blood test. It is often used in conjunction with CA-125 to improve the
sensitivity and specificity of ovarian cancer screening and diagnostic processes. The combination of these markers is also incorporated into the
Risk of Ovarian Malignancy Algorithm (ROMA), which helps in stratifying patients into high or low risk for ovarian cancer.
What are the Limitations of HE4?
Despite its benefits, HE4 is not without limitations. It may not be elevated in all types of ovarian cancer, particularly mucinous or germ cell tumors. Also, certain benign conditions like
renal failure can result in elevated HE4 levels, potentially leading to false positives. Therefore, HE4 should be used in conjunction with other diagnostic tools and clinical evaluations.
What are the Normal Ranges for HE4?
Normal ranges for HE4 can vary based on age and menopausal status. Generally, a serum HE4 level below 70 pmol/L is considered normal for premenopausal women, while levels below 140 pmol/L are typical for postmenopausal women. It is crucial to interpret these values in the context of individual patient factors and other diagnostic findings.Can HE4 be Used for Monitoring Treatment?
Yes, HE4 is also valuable for monitoring treatment response and detecting recurrence in ovarian cancer patients. Serial measurements of HE4 can provide insights into disease progression or remission, helping to tailor treatment strategies effectively.Are There Alternatives to HE4?
While HE4 is a widely used biomarker, other markers and imaging techniques also play essential roles in ovarian cancer diagnosis and management.
CA-125,
transvaginal ultrasound, and
CT scans are commonly used together to provide a comprehensive evaluation.
Conclusion
In summary, HE4 is a crucial biomarker in gynecology, particularly for ovarian cancer detection and monitoring. While it offers significant advantages over other markers, it is essential to use it as part of a broader diagnostic strategy to ensure accurate and effective patient care.
