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Human Epididymis Protein 4 (HE4)

Human epididymis protein 4 (HE4) measurement is used in monitoring patients with treated epithelial ovarian cancer for recurrence or progression.

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HE4 (human epididymis protein 4), also known as WFDC2 (WAP four-disulfide core domain protein 2), is a protein that is primarily produced in the epithelial cells of the reproductive tract. HE4 has gained attention as a biomarker in the field of gynecology, particularly in relation to ovarian cancer.

HE4 is found in various tissues, including the fallopian tubes, endometrium, and ovaries. Elevated levels of HE4 have been observed in the blood of some women with ovarian cancer, making it a potentially useful marker for detecting and monitoring this type of cancer. However, HE4 is not specific to ovarian cancer and can also be elevated in other conditions, such as endometriosis and certain benign gynecologic diseases.

When used in combination with other markers, such as CA125, HE4 can provide additional information for the assessment of ovarian cancer risk. The combination of these biomarkers, along with other clinical factors, is often used to calculate risk scores, such as the ROMA Score (Ovarian Malignancy Risk Algorithm), to aid in the evaluation of ovarian cancer.

HE4 testing is not used as a standalone diagnostic tool but rather as part of a comprehensive evaluation and in conjunction with other diagnostic methods, such as imaging (ultrasound) and clinical assessment.

There are different subtypes of epithelial ovarian cancer, including serous, endometrioid, mucinous, and clear cell, with serous being the most common. HE4 is elevated in more than 90% of serous and endometrioid epithelial ovarian cancers and about 50% of clear cell tumors, but it is not usually elevated in mucinous cancers.

HE4 testing should not be used as a screening test for ovarian cancer or for monitoring patients with mucinous ovarian cancer.

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