Human epididymis protein 4 for differential diagnosis between benign gynecologic disease and ovarian cancer: a systematic review and meta-analysis.

Abstract

OBJECTIVES:

Human epididymis protein 4 (HE4) is a new biomarker for the detection of ovarian cancer. The objective of this review was to assess by meta-analysis the overall diagnostic accuracy of HE4 assay in differentiating malignant ovarian tumors from benign gynecology diseases.

STUDY DESIGN:

The MEDLINE, EMBASE, and Cochrane Library databases were searched for studies published up to June 2012 that evaluated HE4 accuracy. Meta-analysis was used to calculate sensitivity, specificity, the positive likelihood ratio (PLR), the negative likelihood ratio (NLR) and the area under curve (AUC).

RESULTS:

A total of 11 studies with 3395 patients who fulfilled all inclusion criteria were considered in the analysis. No publication bias was found. HE4 had a pooled sensitivity of 0.74 (95% confidence interval (CI), 0.72-0.76) and a pooled specificity of 0.87 (95% CI, 0.85-0.89). Overall, the positive likelihood ratio was 8.04 (95% CI, 4.89-13.21) and the negative likelihood ratio was 0.27 (95% CI, 0.22-0.34). When HE4 was combined with CA125, the sensitivity was higher than that of HE4 alone at the expense of lower specificity.

CONCLUSIONS:

The measurement of serum HE4 is a useful method for differential diagnosis between benign gynecologic disease and ovarian cancer.

• Authors: JiaYing Lin, JinBao Qin, Voramon Sangvatanakul
• Journal: European journal of obstetrics, gynecology, and reproductive biology (Eur J Obstet Gynecol Reprod Biol) Vol. 167 Issue 1 Pg. 81-5 (Mar 2013) ISSN: 1872-7654 [Electronic] Ireland
• PMID: 23228410 (Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review, Systematic Review)
• Copyright: Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Biomarkers, Tumor
• Proteins
• WAP Four-Disulfide Core Domain Protein 2
• WFDC2 protein, human

Topics

• Biomarkers, Tumor (blood)
• Diagnosis, Differential
• Female
• Humans
• Ovarian Neoplasms (blood, diagnosis)
• Proteins (metabolism)
• Sensitivity and Specificity
• WAP Four-Disulfide Core Domain Protein 2