A tumor marker for epithelial ovarian cancer.
Human epididymis protein.
Secreted at high levels by ovarian carcinomas, and expression in normal tissues, including ovarian, is low.
The Human Epididymis Protein 4 (HE4) blood test is a medical diagnostic tool primarily used as a tumor marker to monitor patients already diagnosed with epithelial ovarian cancer.
HE4 helps healthcare providers detect if the cancer is progressing or recurring after initial treatment.
Clinical Uses
Monitoring Recurrence: Its main application is tracking treated ovarian cancer patients for signs of returning disease.
Decreasing levels typically suggest a positive response to treatment, while a significant increase suggests progression.
It is sometimes used alongside the CA 125 test to help evaluate the likelihood of malignancy in women presenting with a pelvic mass.
While CA 125 is the traditional marker for ovarian cancer, HE4 offers specific advantages:
HE4 is less likely to be elevated by common benign conditions like endometriosis, which frequently causes false positives in CA 125 tests.
Early Detection: Some studies suggest HE4 may be more sensitive for detecting early-stage (Stage I) disease than CA 125.
HE4 can be elevated in patients whose tumors do not produce CA 125.
HE4 is not recommended for screening asymptomatic women for ovarian cancer.
Levels can be influenced by age, smoking, and certain conditions like kidney or liver disease.
Specific Cancer Types: It is not effective for monitoring mucinous or germ cell ovarian tumors, as these rarely produce the protein.
Biotin Interference: Patients are typically advised to stop taking biotin supplements (Vitamin B7) for at least 72 hours before the test to avoid inaccurate results.
Reference ranges can vary by laboratory and the patient’s menopausal status: