Ovarian Cancer (HE4)

Ovarian cancer accounts for approximately 17% of all female reproductive cancers and is the most fatal among them. It is predominantly found in older women, especially those with a high-fat diet. Younger women or those taking ovulation-stimulating drugs are also at risk. Additionally, having a family history of ovarian cancer increases the likelihood of developing the disease. About 75% of ovarian cancer cases are epithelial ovarian cancer.

What is Ovarian Cancer (HE4) ?

Human Epididymal Protein 4 (HE4) is a protein found in epithelial ovarian cancer and is usually absent in normal ovarian tissue.

Normal HE4 Levels :

Pre-menopausal women (all ages): 0-92.1 pmol/L
Postmenopausal women (all ages): 0-121 pmol/L

Symptoms of Ovarian Cancer

In its early stages, ovarian cancer typically does not present noticeable symptoms. If symptoms do occur, they are often vague and nonspecific, such as:

Abdominal bloating or pelvic discomfort
Frequent urination
Some individuals may experience indigestion or bloating, resembling gastrointestinal disorders

By the time symptoms become apparent, the tumour is often large or in an advanced stage, making treatment less effective. This is why ovarian cancer has a high mortality rate when diagnosed late.

Blood Tests for Ovarian Cancer Markers

CA125 (Carcinoma Antigen 125 / Carbohydrate Antigen 125):
- A long-established marker for diagnosing and monitoring ovarian cancer.
- However, CA125 alone has limitations, as it may not detect early-stage ovarian cancer and may show elevated levels in non-cancerous ovarian masses.
HE4 (Epididymis Antigen 4):
- A newer method for detecting epithelial ovarian cancer markers.
- When combined with CA125, it increases the sensitivity of early detection, even in stage 1 ovarian cancer.

Recommended to be tested alongside CA125, using the ROMA score to enhance the accuracy of early ovarian cancer detection.

ROMA Value Interpretation:

Premenopausal Women: