He4: Human Epididymis Protein 4

The majority of epithelial ovarian cancer cells generate a protein called Human Epididymis Protein 4 (HE4). The HE4 level in the blood is determined using the HE4 test. In particular situations, this renders the HE4 test useful as a tumour marker.

A woman with epithelial ovarian cancer has a significantly high concentration of HE4 in her blood. When HE4 levels rise, the HE4 test can be performed to check for cancer development or recurrence and gauge how well the treatment is working.

Ovarian cancer is the fifth most common cause of cancer-related death among women. The most prevalent kind of ovarian cancer is epithelial. It contributes to 80% to 90% of ovarian cancer cases and develops in cells lining the ovaries' exterior.

Endometrioid, Clear Cell, Serous, and Mucinous, are a few of the subcategories of epithelial ovarian cancer, with Serous being the most prevalent. According to several research studies, HE4 is typically elevated in Mucinous malignancies but not in the majority of Endometrioid and Serous epithelial ovarian cancers and around half of Clear Cell tumours. So, individuals with other forms of ovarian cancer, such as Germ Cell or Mucinous tumours, are not monitored with HE4.

Women receiving treatment for epithelial ovarian cancer are followed up with Cancer Antigen 125 (CA-125) and Human Epididymis Protein 4. Before therapy, HE4 must be elevated to be effective as a tumour marker. The primary technique employed to monitor ovarian malignancies is CA-125; however, not all tumours have elevated levels. Hence, scientists are still looking for tumour indicators that are more accurate and precise.

The HE4 test at Apollo 24|7 provides valuable insights into epithelial ovarian cancer. The test's findings could indicate any of the following:

Epithelial ovarian cancer typically responds to treatment if HE4 and CA-125 levels were originally elevated and subsequently decreased after the treatment.

If levels increase or remain unchanged, the malignancy has probably not responded. Following cancer treatment or surgery, rising levels of HE4 and CA-125 may be discovered during routine monitoring. This can mean that cancer has resurfaced. 

An elevated ROMA score can indicate that the pelvic mass is more probable to be cancerous in a woman who suffers from a lump in her pelvis and will be having surgery.

The test is ineffective in tracking a woman's ovarian cancer if her baseline HE4 is normal after a diagnosis of epithelial ovarian cancer.

If you have non-epithelial ovarian cancer, this test would not be recommended. If your malignancy does not result in increased HE4 production, the HE4 test would not be practical as a monitoring tool. 
 

Medically reviewed by Dr. Sanjaya Mishra, Radiation Oncology, Apollo Hospitals Old Sainik School Road, Bhubaneswar.