HE4 – not only an ovarian cancer biomarker – a brief review

Abstract

Human epididymis protein 4 (HE4) was firstly identified in epididymal epithelial cells and described as a protease inhibitor playing a role in spermatogenesis. Regarding numerous studies proving its diverse potential as a prognostic and predictive factor in ovarian cancer, it was incorporated into ROMA algorithm. Nevertheless, recent studies have shown that serum level of HE4 is not exclusive to ovarian cancer. As a result, doctors using ROMA algorithm for stratifying patients with ovarian cancer must be aware of other conditions that may affect serum level of HE4. This review comprises different conditions connected with high level of HE4 that might impact ovarian cancer diagnosing process. Moreover, discovering increased HE4 level in various conditions should open discussion about its applicability in diseases other than ovarian cancer.