Comparison Between HE4, CA-125, and Combination of Both HE4 and CA-125 as Tumor Markers for Epithelial Ovarian Carcinoma Patients

Abstract

Purpose. to measure and compare sensitivity, specificity, PPV (Positive Predictive Value). and NPV (Negative Predictive Value) among HE (Human Epididymis) 4. CA (Cancer Antigen)-125, and combination of both HE4 and CA-125 as tumor markers for EOC (epithelial ovarian carcinoma). To investigate possible correlation between HE4 serum concentration with CA-125 serum concentration in EOC. Method and location of research: this research is across-sectional analysis observation study, performed in gynecologic outpatient clinic, gynecologic ward, Clinical Pathology laboratory of dr Soetomo General Hospital Surabaya, and PRODlA Laboratory SampIe and path of research: there ware 53 ovarian tumor patients who underwent surgery in dr Soetomo General Hospital from February until May 20.11 which fulfill our inclusion and exclusion critetis, HE4 and CA-125 serum concentration were examined on one day ptiot to surgery After the final pathology results were obtained, we dropped out 11 patients, the remaining 42 patients were eligible for research analysis whichcom prises of 17 EOC and 25 benign ovarian tumors. Researcher were trying to measure and compare sensitivity, specificity, PPV; and NPV among HE4, CA-125. and combination of both HE4 and CA-125 as tumor markers for EOC. Result: Mc Nemar statistical analysis showed that CA-125 serum concentration has a significant difference with pathology result (p = 00.0.4), meanwhile HE4 serum concentration (p = 1.0.0.0.) and combination ofboth HE4 and CA-125 serum concentration (p = 0..344) does not have any significant difference with pathology result in terms of establishing EOCdiagnosis. Combination of both HE4 and CA-125 has abetter specificity (88.0.0.%) compared to HE4 (80..0.0.%), or CA-125 (20. 0.0.%). HE4 has a bettersensitivity(76.47%) compared to CA-125 (70.59%), or combination ofboth HE4 and CA-125 (58.82%). Combination of both HE4 and CA-125 has abetter PPV (76. 92%) compared to HE4 (72.22%), or CA-125 (37.50.%). HE4 has abetter NPV (83.33%) compared to combination of both HE4 and CA-125 (75.86%), or CA-125 (50..0.0.%). Pearson correiation test were used to measure all ovarian tumor patients, and the research er found a correlation between HE4 serum concentration with CA-I 25 serum concentration, t = 0.453 (p=0.003). Conclusion: combination of both HE4 and CA-125 has the best diagnostic value compared with HE4 and CA- 125 each as asingIe EOC tumor marker There seems to be a correlation between CA-125 serum concentration with HE4 serum concentration in all ovarian tumor patients. although any proof of pathophysiological connection between both have not been established yet. Key Words: HE4. CA-125. sensitivity, specificity, positive predictive value. negative predictive value. epithelial ovarian cancer, benign ovarian tumor