Department of Obstetrics and Gynaecology, Turku University Hospital, University of Turku, Turku, Finland.
Int J Gynecol Cancer. 2011 Dec;21(9):1573-8. doi: 10.1097/IGC.0b013e3182225509.
Human epididymis protein 4 (HE4) is a promising novel serum biomarker for the detection of early-stage epithelial ovarian cancer (EOC) and for the differential diagnosis between benign and malignant ovarian tumors. The objective of the present study was to determine the value of HE4 for monitoring the response to primary therapy in patients with advanced disease.
Serum HE4 and cancer antigen (CA) 125 levels of 10 patients with advanced EOC and one patient with adenocarcinoma of unknown origin were measured preoperatively and during first-line chemotherapy. Seven patients were treated with primary surgery and six cycles of chemotherapy. Response to treatment was evaluated 4 weeks after the completion of chemotherapy using computed tomography. Four patients received neoadjuvant chemotherapy (NACT) before surgery. To evaluate the early response to chemotherapy, changes in serum biomarker levels were compared with metabolic changes of tumors during NACT as detected by positron emission tomography/computed tomography.
The profile of HE4 during primary chemotherapy was in line with radiologic and clinical responses. In the neoadjuvant chemotherapy group, HE4 correlated better with the radiologic response than CA 125.
Assessment of serum HE4 may improve the reliability of response evaluation during chemotherapy for serous epithelial ovarian cancer.
人附睾蛋白 4（HE4）是一种很有前途的新型血清生物标志物，可用于检测早期上皮性卵巢癌（EOC），并用于良性和恶性卵巢肿瘤的鉴别诊断。本研究旨在确定 HE4 用于监测晚期疾病患者一线治疗反应的价值。
术前和一线化疗期间测定 10 例晚期 EOC 患者和 1 例来源不明的腺癌患者的血清 HE4 和癌抗原（CA）125 水平。7 例患者接受了初始手术和 6 个周期的化疗。化疗结束后 4 周，采用计算机断层扫描评估治疗反应。4 例患者在手术前接受了新辅助化疗（NACT）。为了评估化疗的早期反应，通过正电子发射断层扫描/计算机断层扫描比较 NACT 期间血清生物标志物水平的变化与肿瘤代谢变化。
在一线化疗期间，HE4 的特征与影像学和临床反应一致。在新辅助化疗组中，HE4 与影像学反应的相关性优于 CA 125。
评估血清 HE4 可能会提高对浆液性上皮性卵巢癌化疗期间反应评估的可靠性。
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