Wang Lunshan, Sun Yuhuai, Cai Xinan, Fu Guifeng
Department of Clinical Laboratory, The 105th Hospital of the People's Liberation Army, Hefei, 230031, Anhui, People's Republic of China.
Int Urol Nephrol. 2018 Nov;50(11):2043-2048. doi: 10.1007/s11255-018-1930-x. Epub 2018 Jul 13.
In this study, we investigated the diagnostic value of human epididymis protein 4 (HE4) in acute and chronic renal dysfunction and analyzed the correlation between HE4 levels and the results of routine renal function tests. We aimed to provide evidence to establish HE4 as a novel biomarker of renal injury and its appropriate application as a marker of ovarian cancer.
We collected 259 serum samples from hospitalized patients with different causes of renal damage. HE4 serum levels were detected by chemiluminescence and the levels of serum creatinine, urea, and cystatin C were tested by conventional clinical chemical methods.
The levels of HE4 were highest in the acute kidney injury groups and chronic kidney disease groups, although other groups were also significantly higher than the control group. HE4 and creatinine, urea, and cystatin C had a positive linear correlation. In contrast, HE4 and estimated glomerular filtration rate (eGFR) had a negative linear correlation, with a correlation coefficient of - 0.674 (P < 0.01). Area under the receiver-operating characteristic curve analysis showed that HE4 has higher diagnostic value compared with creatinine, urea, and cystatin C in both acute and chronic renal injury patients; however, HE4 and creatinine have a similar diagnostic value. Notably, HE4 concentration gradually increased with a decline of glomerular filtration rate, with significant differences evident between different eGFR stages.
HE4 is a potential biomarker of kidney injury in acute and chronic renal dysfunction. Importantly, clinicians should be aware of this when using HE4 to diagnose ovarian cancer.
在本研究中，我们调查了人附睾蛋白4（HE4）在急性和慢性肾功能不全中的诊断价值，并分析了HE4水平与常规肾功能检查结果之间的相关性。我们旨在提供证据，以确立HE4作为肾损伤的新型生物标志物及其作为卵巢癌标志物的适当应用。
我们收集了259例因不同原因导致肾损伤的住院患者的血清样本。采用化学发光法检测血清HE4水平，采用常规临床化学方法检测血清肌酐、尿素和胱抑素C水平。
急性肾损伤组和慢性肾脏病组的HE4水平最高，尽管其他组也显著高于对照组。HE4与肌酐、尿素和胱抑素C呈正线性相关。相反，HE4与估计肾小球滤过率（eGFR）呈负线性相关，相关系数为-0.674（P<0.01）。受试者工作特征曲线分析显示，在急性和慢性肾损伤患者中，HE4与肌酐、尿素和胱抑素C相比具有更高的诊断价值；然而，HE4和肌酐具有相似的诊断价值。值得注意的是，HE4浓度随着肾小球滤过率的下降而逐渐升高，不同eGFR阶段之间存在显著差异。
HE4是急性和慢性肾功能不全中肾损伤的潜在生物标志物。重要的是，临床医生在使用HE4诊断卵巢癌时应意识到这一点。
