Co-Expression of Lewis y Antigen with Human Epididymis Protein 4 in Ovarian Epithelial Carcinoma

Objective: The main aims of this study were to explore the molecular structural relationship between Human epididymis protein 4 (HE4) and Lewis y antigen by determining their expression patterns and clinical significance in ovarian epithelial carcinoma. Methods: The structural relationship between HE4 and Lewis y antigen was examined using immunoprecipitation and confocal laser scanning microscopy. HE4 and Lewis y were detected in tissues from malignant (53 cases), borderline (27 cases), benign (15 cases) and normal ovarian tissues (15 cases) using immunohistochemical analysis. Results: HE4 was present in ovarian cancer, benign tumor tissues, ovarian carcinoma cells, and culture medium, and contained Lewis y antigen. Moreover, expression of Lewis y antigen in HE4 from ovarian cancer was higher than that from benign tumor (P<0.05). HE4 possibly exists as two protein isoforms, both containing Lewis y antigen. Our immunohistochemistry data revealed significantly higher positive expression rates of HE4 in malignant ovarian tissues, compared to benign tumor and normal tissue (P<0.05), similar to Lewis y antigen levels in ovarian cancer (P<0.05). Notably, tissues displaying marked expression of HE4 simultaneously expressed high levels of Lewis y antigen. A linear correlation between the expression patterns of HE4 and Lewis y antigen was evident. Consistently, double-labeling immunofluorescence experiments illustrated co-localization of HE4 and Lewis y antigen within the same area. Conclusions: HE4 contains Lewis y antigen. Our results further demonstrate a close correlation between the expression levels of the two antigens, which are significantly high in ovarian cancer.