Performance of HE4 and CA125 Alone and in Combination in Predicting Ovarian Cancer

Background: Ovarian cancer is a leading cause of gynaecologic cancer mortality worldwide, due to asymptomatic early stages and lack of effective screening for early detection. Early diagnosis is crucial for survival rates, as advanced-stage ovarian cancer involves poorer outcomes. The identification of reliable biomarkers for early detection has been a significant research focus. This study evaluates the performance of HE4 and CA125 alone and combined in predicting ovarian cancer. Methods: This prospective cross-sectional analytic study was conducted at the Department of Gynaecological Oncology and Department of Obstetrics and Gynaecology, BSMMU, from August 2023 to July 2024. Forty patients with ovarian tumors were admitted and selected for surgical treatment. Serum CA-125 levels were estimated before admission, and HE4 levels were measured in the Department of Microbiology and Immunology, BSMMU, Dhaka, and surgery was performed. The final histopathological report was recorded. Patients were divided into two groups based on pathological findings: women with benign conditions and those with ovarian cancer. CA125 and HE4 levels alone and combined were calculated and compared in both groups. Result: Serum HE4 and CA125 concentrations were significantly higher in ovarian cancer patients compared with those seen in patients with benign disease. In the receiver operating characteristic analysis (ROC), sensitivity was found to be 73.33% and 86.36% for HE4 and CA-125, respectively, and specificity was found to be 90.91% and 60% for HE4 and CA-125, respectively. Combined HE4 and CA-125 was found to have 86% sensitivity and specificity. Conclusion: Measuring serum HE4 and CA125 concentrations may provide higher accuracy than HE4 and CA-125 alone for detecting epithelial ovarian cancer.