Serum human epididymis protein 4 vs carbohydrate antigen 125 for ovarian cancer diagnosis: A systematic review

Simona Ferrarow, Federica Braga, Monica Lanzoni, Patrizia Boracchi, Elia Mario Biganzoli, Mauro Panteghini

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Abstract

Background Human epididymis protein 4 (HE4) measurements in serum have been proposed for improving the specificity of laboratory identification of ovarian cancer (OC). Objective To critically revise the available literature on the comparison between the diagnostic accuracy of HE4 and carbohydrate antigen 125 (CA-125) to confirm the additional clinical value of HE4. Methods A literature search was undertaken on electronic databases and references from retrieved articles; articles were analysed according to predefined criteria. Meta-analyses for HE4 and CA-125 biomarkers with OR, diagnostic sensitivity, specificity, positive (LR+) and negative (LR-) likelihood ratios as effect sizes were performed. Results 16 articles were originally included in metaanalyses, but two for HE4 and one for CA-125 were eliminated as outliers. Furthermore, for HE4 a publication bias was detected. ORs for both HE4 (37.2, 95% CI 19.0 to 72.7, adjusted for publication bias) and CA-125 (15.4, 95% CI 10.4 to 22.8) were significant, although in a heterogeneous set of studies (p

Original languageEnglish
Pages (from-to)273-281
Number of pages9
JournalJournal of Clinical Pathology
Volume66
Issue number4
DOIs
Publication statusPublished - Apr 2013

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ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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