Prognostic Role of Human Epididymis Protein 4 (HE4) in Ovarian Cancer Treatment: Our Point of View

In the last 10 years, the marker “Human Epididymis protein 4 (HE4)” for the management of gynecological tumors has entered powerfully in the world literature. At the moment, carrying out an accurate research in the main scientific portals such as PubMed, we can find more than 2,000 works concerning Cancer antigen-125 (Ca125), but those concerning HE4 are less than 400. The assessment of the prognostic significance of Ca125 has been described in more than 1000 scientific papers, whereas in the case of HE4 such works are only about 100. The HE4 gene product is an N-glycosylated protein which is secreted into the extracellular environment and can be detected in the bloodstream of patients with ovarian cancer. Diagnostic strategies for discriminate benign neoplasm from malignant Epithelial Ovarian Cancer (EOC) use tumor markers, imaging exams and combination algorithms. Ca125 is the best documented circulating marker and the most frequently recommended by clinical practice guidelines, despite its low specificity. To compensate for the low specificity of Ca125, new markers were studied: HE4 is one of the most promising; HE4 has demonstrated good sensitivity and specificity in detecting EOC, overcoming the traditional role of Ca125. So, the role currently assumed by HE4 marker has been to aid in the diagnosis of malignant ovarian neoplasm. In recent years, however, these markers (HE4 and Ca125) have assumed an important significance in the assessment of prognosis and response to chemotherapy.