A Comparative Study of Cancer Antigen 125 (CA-125) and Human Epididymis Protein 4 in Ovarian Cancer Detection

Introduction: Non-neoplastic and neoplastic lesions of the ovary pose a great challenge to gynecological oncologists.Early detection is critical for improved prognosis, but current screening methods, including cancer antigen 125 (CA-125) and imaging techniques, have limitations.Thus, great efforts are directed at identifying novel markers such as human epididymis protein 4 (HE4) to improve the diagnostic performance of ovarian cancers.Aims and objectives: The primary aim of the present study was to compare the specificity and sensitivity of serum levels of CA-125 and HE4 in the detection of ovarian cancers by taking histopathology as the gold standard.Materials and methods: A cross-sectional descriptive study was conducted over a period of one year after approval by the Institutional Ethical Committee (Ref No: FMIEC/CCM/429/2022). Patient Selection: Patients with pelvic masses identified through imaging were included in the study and classified according to histopathology into malignant, borderline, benign, and non-neoplastic lesions.Malignant cases were further staged (I-IV) following FIGO 2014 standards, and blood samples were collected prior to surgery.Patients with renal failure or undergoing cytotoxic chemotherapy or diagnosed with nongynecological malignancies following surgery were excluded.Marker assays: Cancer Antigen 125 levels were measured using electrochemical luminescence.Human epididymis protein 4 analysis was performed with leftover samples using ELISA following validation according to the manufacturer's protocols.Method verification was done by running standards (concentration of stds 0, 20, 100, 200, 400, 800 [PM]).Results: The serum samples of 129 patients were analyzed, and the distribution of ovarian lesions was as follows: 19 (14.72%) normal ovaries, 14 (10.85%)non-neoplastic lesions, 30 (23.25%) benign tumors, 5 (3.87%) borderline tumors, and 61 (41.4%) malignant ovarian tumors.