Oncomarker HE4: interpretation of analysis, norm and pathology24.05.2022
Ovarian cancer is the second most common among all cancers of the female genital area. This makes early detection of the disease relevant, and special markers help in this: an increase in their values in women helps to determine the presence of a tumor. The tumor marker HE4 is used to diagnose ovarian cancer. The attending physician is engaged in deciphering the analysis, identifying the norm or pathology.
Oncomarker HE4: a new standard in cancer detection
For many years, the main focus was on the CA 125 tumor marker: whether it was elevated or decreased meant good or bad news for a woman. Thus, an increase in the values of this marker indicated a recurrence of cancer, while a decrease indicated the effectiveness of the treatment and remission or a complete victory over oncology.
But the main problem was that this analysis was unsuitable for diagnosing cancer in the early stages. It could give false-positive results in the presence of non-cancer ovarian diseases: cysts and other benign neoplasms. As a result, the detection of ovarian cancer in most cases occurred at late stages, which shows the low sensitivity of the test and its insufficient effectiveness.
HE4 protein came to the rescue – a window marker, whose name stands for “human testicular protein”, for the first time this protein was found in the epididymis in men. HE4 is used to diagnose ovarian cancer, to monitor the effectiveness of treatment. The concentration of this substance increases sharply already at the first stage of the malignant process in the ovaries, and at the same time its values remain normal in the presence of benign tumors. Thanks to the test with the definition of this oncomarker, it became possible to identify malignant processes in the ovaries at the stage when they do not yet manifest clinical symptoms and are best amenable to therapy.
Features of the analysis
The study requires venous blood. The accuracy of the results largely depends on the correct preparation for the analysis:
- Blood sampling should take place in the morning, preferably in the morning.
- Before donating blood, do not eat breakfast or drink any drinks other than water.
- 12-24 hours before donating blood, you should completely stop smoking, drinking alcohol and exclude increased physical and emotional stress.
In addition, it is important to stop taking any medications 7-10 days before blood sampling. If for some reason this is not possible – for example, you are undergoing a course of medication that cannot be interrupted – be sure to tell your doctor. List the names of all drugs taken and their dosage. Such information will allow you to adjust the results of the analysis to new circumstances and avoid misinterpretation of the test.
Any other diagnostic measures should be prescribed after the test, as they are potentially capable of distorting the blood picture, which will give the doctor false information.
Deciphering the results
When deciphering the analysis for the oncomarker HE4 , reference values are used. They mean the average values found in healthy people who underwent such an examination.
The norm in women is related to the age of the patient and is as follows:
- under 40 years old – below 60.5 pmol / l;
- 40-49 years – below 76.2 pmol / l;
- 50-59 years – below 74.3 pmol / l;
- 60-69 years – below 82.9 pmol / l;
- from 70 years and older – up to 104.0 pmol / l.
Exceeding these values with a high degree of probability indicates malignant processes in the ovaries and / or the endometrial layer of the uterus. But the combination of tests for oncomarkers HE4, CA125 and ROMA demonstrates the greatest diagnostic accuracy.
In addition, it is important to be aware that some circumstances may artificially increase the level of HE4 or change the formula, as a result of which the reliability of the results becomes doubtful. These factors include taking oral contraceptives, pregnancy, surgery, etc. Therefore, with an increase in the level of HE4, a control study may be required.
Indications for analysis for oncomarker HE4
This study is recommended for such diseases and conditions:
- identified neoplasm in the pelvic organs and the need to determine its nature;
- control over benign tumors of the uterus and ovaries for the purpose of early detection of their malignancy;
- already diagnosed oncological disease of the mammary glands: ovarian cancer can develop in parallel, and it is important to identify it in time.
- hereditary predisposition to oncological processes;
- harmful working conditions, contact with carcinogens and other circumstances that put a woman at increased risk for developing ovarian cancer.
At the discretion of the doctor, this analysis may be prescribed for other indications, if the specialist considers such testing appropriate. When deciphering the result of the analysis for the HE4 oncomarker, the doctor determines whether the patient has a norm or there is a pathology. But even if the concentration of the HE4 gene is increased, this should not be taken as a sentence. In the early stages, oncological diseases are successfully treatable, which practically guarantees you a long and happy life.
See below: norm CA 125 of a tumor marker in women