ArticleJournal of ovarian research2012
High preoperative blood levels of HE4 predicts poor prognosis in patients with ovarian cancer.
Article in Journal of ovarian research, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 62 citations in OpenAlex.
- The impact of varying levels of residual disease following cytoreductive surgery on survival outcomes in patients with ovarian cancer: a meta-analysis.BMC women's health · 2024Pooled it
- Correlation between progression-free survival and overall survival in patients with ovarian cancer after cytoreductive surgery: a systematic literature review.International journal of gynecological cancer : official journal of the International Gynecological Cancer Society · 2023Pooled it
- HE4 is a novel tissue marker for therapy response and progestin resistance in medium- and low-risk endometrial hyperplasia.British journal of cancer · 2016Trial
- Prognostic value of CA125, HE4, ROMA, and CPH-I in advanced epithelial ovarian cancer.BMC cancer · 2026Article
- MicroRNA targeting: A novel therapeutic intervention for ovarian cancer.Biochemistry and biophysics reports · 2023Review
- Evaluation of He4 Use in the Diagnosis of Ovarian Cancer: First and Second Recurrence, and an Analysis of HE4 Concentration during Second- and Third-Line Chemotherapy.Diagnostics (Basel, Switzerland) · 2023Article
- The Discrepancy between Preoperative Tumor Markers and Imaging Outcomes in Predicting Ovarian Malignancy.Cancers · 2022Article
- Human epididymis protein 4 (HE4) is a novel biomarker for fibrosis in IgG4-related disease and can predict poor prognosis.RMD open · 2022Article
- The Role of Human Epididymis Protein 4 in the Diagnosis and Prognosis of Diseases: An Umbrella Review of Systematic Reviews and Meta-Analyses of Observational Studies.Frontiers in medicine · 2022Review
- HE4 overexpression decreases pancreatic cancer Capan-1 cell sensitivity to paclitaxel via cell cycle regulation.Cancer cell international · 2020Article
- Diagnostic and prognostic role of HE4 expression in multiple carcinomas: A protocol for systematic review and meta-analysis.Medicine · 2019Article
- Article
- Integrated multiomic predictors for ovarian cancer survival.Carcinogenesis · 2018Article
- HE4 level in ascites may assess the ovarian cancer chemotherapeutic effect.Journal of ovarian research · 2018Article
- Prognostic values of HE4 expression in patients with cancer: a meta-analysis.Cancer management and research · 2018Article
- Could HE4 level measurements during first-line chemotherapy predict response to treatment among ovarian cancer patients?PloS one · 2018Article
- Diagnostic usefulness of the Risk of Ovarian Malignancy Algorithm using the electrochemiluminescence immunoassay for HE4 and the chemiluminescence microparticle immunoassay for CA125.Oncology letters · 2016Article
- Can ROMA algorithm stratify ovarian tumor patients better when being based on specific age ranges instead of the premenopausal and postmenopausal status?Tumour biology : the journal of the International Society for Oncodevelopmental Biology and Medicine · 2016Article
- Serum HE4, CA125, YKL-40, bcl-2, cathepsin-L and prediction optimal debulking surgery, response to chemotherapy in ovarian cancer.Journal of ovarian research · 2014Article
- The emerging role of HE4 in the evaluation of epithelial ovarian and endometrial carcinomas.Oncology (Williston Park, N.Y.) · 2013Review
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
unlabelledThe aim of this study was to assess the clinical value of preoperative blood levels of HE4 as a predictor of overall survival in patients with ovarian cancer and to validate previous data of HE4 and the ROMA algorithm including HE4 and CA125 in discriminating benign and malignant ovarian tumors. EXPERIMENTAL
designThe preoperative plasma levels of HE4 and CA125 were analyzed with ELISA in 312 patients with adnexal lesions. Tumors were classified as benign (n= 206), borderline (i.e. low malignant potential tumors) (n= 25), and well (n= 14), moderately (n= 15), and poorly (n= 51) differentiated malignant.
resultsIn univariate Cox regression analyses high levels (dichotomized at the median) of HE4, CA125, increased age (continuous variable), advanced-stage of disease 2-4, histological grade 3 and non-optimal tumor debulking at primary surgery were all significantly associated with shorter overall survival. A multivariate Cox regression model including pre-operative available covariates HE4 and CA125 both dichotomized at median in addition to age as continuous variable showed that high levels of HE4 was an independent prognostic marker for worse prognosis HR 2.02 (95% CI 1.1-3.8). In postmenopausal women the ROMA algorithm gave the highest AUC of 0.94 (95% CI, 0.90-0.97) which was higher than the separate markers HE4 AUC 0.91 (95% CI 0.86-0.95) and CA125 AUC 0.91(95% CI 0.87-0.96).
conclusionsHigh concentration of plasma HE4 is an independent preoperative marker of poor prognosis in patients with ovarian cancer. The algorithm ROMA discriminates in postmenopausal women between malignant and benign tumors with an AUC of 0.94.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.