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REVIEW  INNOVATIONS IN GYNECOLOGY AND OBSTETRICS 

Minerva Ginecologica 2019 February;71(1):36-43

DOI: 10.23736/S0026-4784.18.04328-9

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

The role of human epididymis protein 4 as a biomarker in gynecologic malignancies

Francesco PLOTTI 1 , Giuseppe SCALETTA 2, Corrado TERRANOVA 1, Roberto MONTERA 1, Carlo DE CICCO NARDONE 1, Daniela LUVERO 1, Gianmarco ROSSINI 1, Alessandra GATTI 1, Teresa SCHIRÒ 1, Michele MONCELLI 1, Federica GUZZO 1, Roberto ANGIOLI 1

1 Department of Obstetrics and Gynecology, Campus Bio-Medico University, Rome, Italy; 2 Unit of Gynecologic Oncology Unit, Department of Women’s and Children’s Health, A. Gemelli University Polyclinic Foundation, Rome, Italy



INTRODUCTION: The serum levels of glycoprotein human epididymis protein 4 (HE4) have been widely investigated in patients with ovarian cancer as a tumor marker to differentiate benign gynecological tumors from ovarian cancers (OC). A few studies demonstrated the promising role of HE4 in endometrial cancer (EC) too. The aim of this review is to provide an outline of published studies investigating HE4 in the diagnosis of gynecologic malignancies, focusing on its role in OC and EC.
EVIDENCE ACQUISITION: We conducted a systematic review of literature from January 1952 to June 2018 on the role of HE4 in OC and EC focusing on the diagnostic power in terms of sensitivity and specificity.
EVIDENCE SYNTHESIS: We identified 49 articles with an overall sample size of 12,631 patients in OC group and five studies with an overall sample size of 1221 patients in EC group. We stated that HE4 had a pooled sensitivity of 78% and specificity of 86% in the detection of borderline or malignant OC and a pooled sensitivity of 78.8% and specificity of 100% in EC diagnosis.
CONCLUSIONS: This systematic review confirms the importance of HE4 in the diagnosis of epithelial ovarian cancer and its promising role in endometrial cancer (endometrioid histology).


KEY WORDS: Human WFDC2 protein - Ovarian neoplasms - Tumor biomarkers

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