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HE 4 is a tumor marker used for the comprehensive diagnosis of epithelial ovarian cancer and monitoring previously diagnosed ovarian cancer.

The HE4 gene is among the most commonly expressed genes in epithelial ovarian carcinoma cells. This pathology is associated with increased secretion of the HE4 protein into the bloodstream.

Recent studies have identified HE4 as a promising tumor marker for epithelial ovarian cancer.

Currently, CA 125 is widely used for diagnosing suspected ovarian cancer and monitoring previously diagnosed cases. However, CA 125 has limitations in sensitivity and specificity, as elevated levels can be observed in tumors of both gynecological and non-gynecological origins, as well as in various benign conditions.

According to research, HE4 offers greater specificity than CA 125 in distinguishing benign (both gynecological and non-gynecological) conditions from ovarian cancer and in differentiating ovarian cancer from other malignancies of non-ovarian origin.
Additionally, HE4 is considered the best indicator for detecting Stage I ovarian cancer.

  • Sample: Blood drawn from a vein.
  • Fasting for at least 12 hours before the test is required.
  • Discontinue medications 24 hours before testing (if approved by the doctor).
  • Improved differentiation of benign and malignant gynecological conditions (used with CA 125 for early ovarian cancer detection).
  • Assessing the risk of epithelial ovarian cancer (in combination with CA 125 and ROMA index calculation).
  • Ovarian cancer cases with normal CA 125 levels (alternative marker for treatment monitoring).
  • Monitoring previously diagnosed ovarian cancer cases with elevated HE4 (assessing disease progression and detecting recurrence).

Causes of Increased HE4 Levels

Malignant Conditions:

  • Epithelial ovarian cancer
  • Endometrial cancer
  • Non-small cell lung cancer

Benign Conditions:

  • Kidney failure, often associated with various underlying diseases

Important Considerations

  • Patients with confirmed ovarian cancer may have HE4 levels within the reference range.
  • Some rare ovarian cancer types (e.g., germ cell tumors, mucinous tumors) rarely elevate HE4.
  • HE4 levels may be elevated in certain benign conditions.
  • HE4 levels alone are not absolute proof of the presence or absence of malignancy.