Preliminary Report of Routine use of CA-125 and HE-4 in 26 Consecutive Patients Operated in a National Cancer Center

Background: The role of serological tumour markers for early diagnosis of ovarian cancer is still debated. Actually, Carbohydratic Antigen 125 (CA 125), is widely used in primary diagnosis of cancer but it has a particular role in monitoring response to treatment in ovarian cancer. Due to the low specificity, new strategies and new biomarkers are needed. Recently another glycoprotein, called human Hepididymis Protein 4 (HE4), has been proposed as a circulating marker for ovarian cancer. We evaluated the potential role of CA 125 and HE4 on a consecutive series of patients undergoing surgery at a National Cancer Center in order to evaluate if routine use of these markers may help the clinicians to establish the diagnosis and, thus, the correct treatment option. Methods: Twenty six serum samples were obtained from peripheral blood of the same number of consecutive patients submitted to surgical treatment. HE4 and CA125 levels were detected and cross related to clinical-pathological characteristics of the patients enrolled. The results were analysed by one way ANOVA analyses and by t-test. Results: There was no statistically significant difference between patients with any kind of cancer and patients with benign disease for HE-4 (p-value>0,05), while the difference between benign disease and cancer patients for CA125 was significant (p-value 0,0411). Among the study population, the highest values of CA 125 was observed in endometriosis patients as compared to cervical and vulvar cancer. Infact, among the 26 patients, 8 patients affected by benign disease had CA -125 (Average: 72, 81 pmol/ml) serum values higher than normal levels as compared to 7 patients with cervical cancer (Average: 19,83 pmol/ml) and 9 patients affected by vulvar cancer (Average: 15,01 pmol/ml).In reverse, patients with benign disease experienced, on average, lower values of HE-4 as compared to cervical and vulvar cancer. In fact, the 8 patients affected by benign disease had HE serum level’s average equal to 66,8 pmol/ml while those affected by cervical and vulvar cancer had HE serum level’s average respectively of 76,67 and 99,5 pmol/ml. Both CA125 and HE4 expression resulted statistically significant comparing pre-menopausal and post-menopausal values. Conclusion: In our experience, CA 125 seems to be more suitable if compared to HE4, but, now studies on larger cohort are in progress with the aim to establish the potential of HE4.