Abstract
Background: Mortality in case of ovarian malignancy is high due to late diagnosis. Early and accurate diagnosis can improve the case specific management. HE4 (human epididymis protein 4) which is proved to be overexpressed in the ovarian cancer cells, is considered a new biomarker for ovarian cancer diagnosis. Aims and objectives: The study was undertaken to evaluate the immunohistochemical expression of HE4 in various epithelial ovarian neoplasm. Material and Methods: It was a cross sectional, prospective, single institution based study, conducted in the department of Pathology in collaboration with the department of Gynecology and Obstetrics, from December 2016 to January 2019 in our institution. A total 71 cases were selected for this study. Results: Serous tumour was the most common epithelial tumour followed by mucinous tumour. Highest percentage of expression of HE4 was seen in high grade serous cancer and malignant endometrioid tumour. Benign serous and mucinous tumour shows negative expression mostly. We found statistically significant correlation between HE4 expression and different types of epithelial ovarian tumours (p=0.000). Conclusions: HE4 was highly expressed in malignant ovarian tumour especially serous and endometrioid carcinoma and can be used as an important biomarker for malignant ovarian neoplasm. Expression in high grade ovarian serous cancer supports its prognostic value also.
Highlights
Ovarian carcinoma has the highest mortality rate among all gynaecological malignancies
Serous tumour was the most common epithelial tumour followed by mucinous tumour
human epididymis secretory protein 4 (HE4) was highly expressed in malignant ovarian tumour especially serous and endometrioid carcinomaand can be used as an important biomarker for malignant ovarian neoplasm
Summary
Ovarian carcinoma has the highest mortality rate among all gynaecological malignancies. It is the sixth most common cancer in women worldwide.[1] WHO classified ovarian tumours into 5 types, of which surface epithelial tumour is the most common. WHO recognizes seven histological subtype of epithelial ovarian tumour.[2] Serous carcinoma which is of epithelial origin, the most common type of ovarian carcinoma carries the poorest prognosis, make upto 30-70% of all diagnosis.[3] Ovarian carcinoma most often diagnosed late due to their subtle and undetected clinical symptoms,[4] and this leads to high mortality rate.[5] Though ultrasound is a routinely performed imaging technique, high levels of expertise is required to differentiate between benign and malignant ovarian tissues. There is a need to develop biomarkers for early diagnosis. Mortality in case of ovarian malignancy is high due to late diagnosis. HE4 (human epididymis protein 4) which is proved to be overexpressed in the ovarian cancer cells, is considered a new biomarker for ovarian cancer diagnosis
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