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Background: Ovarian cancer is the leading cause of gynaecological cancer related deaths all over the globe. Epithelial ovarian cancers are usually diagnosed at an advanced stage (FIGO Stage III and IV). There is a high probability of disease recurrence in spite of an initial aggressive primary therapy. Early detection of recurrence can help in providing survival advantages to the patients. Human epididymis protein (HE4) seems to act as a potential marker for earlier detection of ovarian cancer recurrence.
Objectives: The purpose of this study was to explore the clinical value of serial measurements of HE4 during follow-up for the early detection of recurrence of epithelial ovarian cancer and to find out the additive value of combining HE4 with cancer antigen 125 (CA-125).
Materials and methods: One hundred patients after completion of their primary therapy were followed up for a period of one year (July 2020-August 2021) in order to detect biochemical recurrence using HE4 and CA-125.
Results: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of HE4 in the detection of recurrence of epithelial ovarian cancer were 87.1% (95%CI: 71.15-94.87), 91.3% (95%CI: 82.30-95.96), 81.8% (95%CI: 65.61-91.39), 94.0% (95%CI: 85.63-97.65) and 90.0% (95%CI: 82.56-94.48) respectively. The combined sensitivity, specificity, positive predictive value, negative predictive value and accuracy of HE4 and CA-125 for early detection of recurrence was found to be 96.8% (95%CI: 83.81-99.43), 81.2% (95%CI: 70.39-88.65), 69.8% (95%CI: 54.89-81.40), 98.3% (95%CI: 77.86-91.47), and 86.0% (95%CI: 71.12-86.66) respectively.
Conclusion:The results of our study add more evidence to the role of HE4 in the timely detection of ovarian cancer recurrence compared to the traditional marker CA-125 with increased sensitivity and specificity.
Keywords:Ovarian cancer recurrence; Human epididymis protein4 (HE4); CA-125; Cancer.