DIAGNOSTIC SIGNIFICANCE OF THE HE-4 TUMOR MARKER IN THE STAGING OF OVARIAN CANCER

Introduction. Ovarian cancer is not a rare pathology and accounts for 4–6 % of all malignant neoplasms in the female population. Diagnostics of ovarian cancer at an early stage is a key approach to improving the effectiveness of treatment for this pathology. The use of sensitive serological tumor-associated markers is considered an adequate approach for diagnosis, monitoring of treatment efficacy and preclinical detection of recurrence for tumors of a number of localizations, in particular ovarian cancer.

The objective. To evaluate the diagnostic significance of the HE-4 tumor marker in comparison with the CA-125 tumor marker depending on the stage of malignant tumors of the ovaries (MTO).

Methods. The paper is based on the authors’ own clinical observations of 245 patients for the 2015 to 2017 period in SI “Grigoriev Institute for Medical Radiology of National Academy of Medical Sciences of Ukraine». The article presents the results of the study of the HE-4 and CA-125 tumor markers levels in 181 patients with I–IV stage (basic group) of MTO and in 64 women with benign ovarian neoplasms (control group). The criterion for inclusion in the study was an exclusively voluntary informed consent of the patient; exclusion from the study was carried out in the event of the patient's refusal to continue to participate in the study at any stage or if the specific clinical case was not corresponding to the purpose and objectives of the study. In the course of the study clinical, biochemical, immunoenzymatic and radiological methods of examination were used. Statistical processing of the data was carried out using the «STATISTICA 10.0» software package.

Results. The mean levels of expression of the HE-4 tumor-associated marker are consistently increasing in accordance with the spread of the process, differing significantly in-between them when comparing the early and late stages of MTO. The incidence of HE-4-positive cases is quite high regardless of the stage of the process. Sensitivity of the HE-4 tumor-associated marker irrespective of the disease stage was 92.82 %, CA-125 – 89.50 %, however, the specificity of the HE-4 marker significantly exceeds the specificity of CA-125 and is 95.31 and 60.92 % respectively. The sensitivity of the HE-4 protease inhibitor is significantly higher than that of CA-125 in the early stages of the development of the malignant process (stage I–II) and practically does not differ in the neglected stages of malignant tumors of the ovaries. The analysis of auxiliary informative criteria has shown the probable advantage of the HE-4 tumor marker in comparison with CA-125 in all parameters, except for the incidence of false negative results.

Conclusions. It was discovered that the HE-4 tumor marker is stage dependent. It has been established that the specificity of the protease inhibitor HE-4 exceeds the specificity of the oncofetal protein CA-125 by 1,5 times, which allows recommending its use in the diagnosis of malignant tumors of the ovaries.

Key words: malignant tumors of the ovaries; tumor-associated markers; HE-4; CA-125; diagnostic significance.

Kateryna V. Nemaltsova,

Olena M. Sukhina,

Vladyslav S. Sukhin

 
SI “Grigoriev Institute for Medical Radiology of National Academy of Medical Sciences of Ukraine», 

Kharkov, Ukraine

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Nemaltsova K.V., Sukhina Ye.M., Sukhin V.S. Diagnostic significance of the HE-4 tumor marker in the staging of ovarian cancer. Nauka i Zdravookhranenie [Science & Healthcare]. 2017, 6, pp. 28-42.