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1. What is human epididymis protein 4 (HE4)?

It is a new tumor marker for ovarian cancer, which ranks third among the three major gynecologic malignancies in terms of incidence. It is not easy to be detected because of its early symptoms. As the time of cancer increases, the 5-year survival rate of patients decreases from 70%-90% to 20%, so early diagnosis is crucial to the cure rate of ovarian cancer.

HE4, called human epididymis protein 4, is a sensitive indicator for detecting ovarian cancer and is one of the antigen markers. It is another highly recognized tumor marker for epithelial ovarian cancer after CA125. Human epididymis protein 4 (HE4) is not expressed in the normal ovarian surface epithelium, while it is significantly highly expressed in serous ovarian cancer and endometrioid ovarian cancer.

Compared with the glycoantigen CA125, which is less disturbed by external factors, the cancer antigen 125 marker is generally disturbed by many factors such as inflammation, endometriosis, and pregnancy, which can cause elevation, whereas human epididymis protein 4 (HE4) is generally not affected by these factors. The combined test of he4 human epididymis protein 4 and CA125 is more meaningful for detecting ovarian cancer.

Human epididymis protein 4 (HE4) combined with CA125 has high clinical value in the early diagnosis of epithelial ovarian cancer, disease monitoring, postoperative recurrence monitoring, as well as in the differential diagnosis of benign tumors. HE4 protein also has some sensitivity in the diagnosis of endometrial cancer. It is also seen in other tumors, such as the lung, breast, and pancreas. It is also seen in the increase of human epididymis protein 4. It is also increased in some gynecological inflammatory diseases, ovarian cysts, and other benign tumors.

2. Clinical significance of human epididymis protein 4 (HE4)
HE4 tumour marker is expressed at high levels in ovarian cancer tissues and serum, as well as in endometrial, lung, colon, and breast cancers. Increased percentage of detectable serum human epididymis protein 4 (HE4) levels have been used as an aid to monitor the recurrence and progression of disease in patients with invasive epithelial ovarian cancer.

The association of human epididymis protein 4 (HE4) levels with clinical responsiveness to treatment or recurrence status in patients with ovarian cancer examined by CT imaging suggests that human epididymis protein 4 (HE4) may be an important indicator of ovarian cancer recurrence.

Elevated levels of HE4 may also be seen in other malignant disorders such as breast cancer, endometrial cancer, and, rarely, benign disorders.

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