“Is HE4 useful in the differentiation between primary ovarian cancer and ovarian metastases from other malignancies?”

Boldingh, Q.J.A.J. (2014) “Is HE4 useful in the differentiation between primary ovarian cancer and ovarian metastases from other malignancies?”. thesis, Medicine.

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Abstract

Background: About 5-15% of all malignant ovarian tumors are metastases from other malignancies such as gastro-intestinal tumors, breast cancer or melanoma. Also other gynaecological tumors can metastasize to the ovaries. It is crucial to differentiate between primary ovarian cancer and ovarian metastases because treatment is different. The clinical value of Human Epididymis secretory protein 4 (HE4) as a serum biomarker in primary ovarian cancer has been established. However, the possible clinical use of HE4 in the differentiation between primary ovarian cancer and ovarian metastases from other malignancies has never been investigated. Objective: To evaluate whether HE4 can differentiate between primary ovarian cancer and ovarian metastases of gastro-intestinal origin, breast cancer and melanoma. Methods: HE4 was measured in 209 patients with ovarian metastases (n=62) or primary ovarian cancer (n=147). Clinical patient data were collected. Sensitivity, specificity (90%, 95%, 98%) and area under the curve (AUC) were calculated, using the Receiver Operating Characteristic (ROC) methodology. CA125 was measured to enable comparison with HE4. Results: The median HE4 value of the ovarian cancer group (431 pmol/L) was significantly higher than the median of the ovarian metastases group (68 pmol/L, p=0,0001). Similar for the age groups from 40-60 years and older then 60 years (p=0,0001 and p=0,05). The best cut-off value to differentiate ovarian metastases from primary ovarian cancer is 115 pmol/L corresponding with an AUC 0.86, sensitivity 81% and specificity 80%. Conclusion: HE4 serum levels may be useful in the differentiation of ovarian metastasis from primary ovarian cancer. If serum HE4 is under the cut-off value of 115 pmol/L, ovarian metastases from other malignancies should always be excluded in patients presenting with an ovarian tumor.

Item Type:	Thesis (Thesis)
Supervisor name:	Arts, Dr. H.J.G.
Supervisor name:	Lok, Dr. C.A.R. and Korse, Dr. C.M. and Stiekema, Drs. A. and Kenter, Prof. Dr. G. G.
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:59
Last Modified:	25 Jun 2020 10:59
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1904

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