Premenopozal Adneksiyal Kitlelerin Ayırıcı Tanısında He4 Ün Rolü

Role of He4 in the Differential Diagnosis of Premenopausal Adnexal Lesions Abstract

Purpose: To evaluate plasma values of human epididymal protein (HE4) and it‟s use in the differential diagnosis of malign adnexal masses. Also, this biomarker compared with CA 125. Patients and Methods: 70 premenopausal patients who were admitted to Istanbul University Cerrapasa Medical Faculty, Gynecolgjcal Oncology, and Gynecology Department were included in this study. (age 15-50). Venous blood samples were taken from all patients within ten days before the operation. The sera of the collected blood were separated and tumor marker levels such as CA 125, CA 19.9, and HE4 were investigated in the serum of each patient. Serum HE 4 levels were determined using the enzyme-labeled Immun method (Enzyme-linked immunoassay; Elisa). The results were evaluated at a 95% confidence interval and a significance level of p <0.05. Results: Malignant adnexal masses grouped by histologic results; 20 (%55) were serous cystadenocarcinoma, 4 (%11) were mucinous cystadenocarcinoma, 3 (%8) were endometrioid adenocarcinoma, 4 (%11). The mean age of patients was 34.08 ± 9,19 in malign and 33.44 ± 10,46 in the benign group. There was no statistical difference found on behalf of age and mass size between malignant and benign groups p>0.05. In the malignant group of patients, HE4 and CA 125 levels were found to be statistically significantly higher than the benign group. Conclusion: We have shown that CA 125 and HE4 proteins are significantly increased in malignant ovarian tumors. We showed that HE4 protein is more specific than CA 125 in premenopausal patients in differentiating malignant and benign tumors. Our results suggest that clinicians should evaluate serum HE4 levels as a more reliable marker than serum CA 125 levels in women in the reproductive phase if the symptoms of ovarian cancer such as bloating, abdominal or pelvic pain or abnormal bleeding are accompanied by a pelvic mass.

Keywords: Premenopausal Adnexal Lesion, He4