Diagnostic Value of HE4 in Distinguishing Malignant from Benign Pelvic Masses

Purpose To evaluate the diagnostic value of HE4 for distinguishing malignant pelvic masses from benign ones. Methods Eighty-five female patients diagnosed with pelvic masses and underwent elective surgery were enrolled. Preoperative serum samples for CA125, ROMA and HE4 were obtained, and the values were calculated. The diagnostic performances of HE4, CA-125 and ROMA, and best cutoff points were evaluated by using receiver operating characteristics curves and calculating sensitivity, specificity and area under curve (AUC). Results Among 85 women (47 premenopausal and 38 postmenopausal), 23 patients were diagnose with malignant pelvic masses while 62 were with benign. Significant diagnostic performance in discriminating malignant masses from benign ones and best cutoff points for CA125: premenopause, specificity 92.3 %, sensitivity 100 %, AUC >= 0.981, best cutoff >95.5, postmenopause, specificity 82.6 %, sensitivity 100 %, AUC >= 0.941, best cutoff point >58.15; for ROMA: postmenopause, specificity 73.9 %, sensitivity 100 %, AUC C0.904, best cutoff point >28.91. There was no significant value of HE4 alone in differentiation of pre-post menopausal benign and malignant groups (p = 0.910, p = 0.347). Conclusions HE4 may have more diagnostic value when used in combination with other biomarkers in differential diagnosis of malignant pelvic masses.