Introduction/Background Reliable histopathological classification of ovarian tumours is a prerequisite for optimal therapeutic approach. Combining multiple tissue and serum markers allows better categorization.

Methodology 127 patients with ovarian tumour were included in the study (21 with tumour-like lesions-TLL, 53 with benign cysts, 11 with borderline, 33 with malignant cysts, 9 with metastasis). Levels of circulatory HE4, tissue HE4 and Ki-67 were measured. Level of statistical significance between subgroups of patients was tested with Kruskal-Wallis test.

Results Mean of serum HE4(pmol/L): 57,07 (TLL), 66,48 (benign cysts), 67,48 (borderline), 619,26 (malignant cysts), 128,23 (metastasis). We found level of statistically significant differences P<0,001 between: benign vs. malignant cysts, benign cysts vs. metastasis, borderline vs. malignant cysts, TLL vs. malignant cysts, TLL vs. metastasis. We also found statistical difference between borderline vs. metastasis (P=0,003) and malignant cysts vs. metastasis (P=0,010).

Mean of tissue HE4(%): 5,74 (TLL), 52,63 (benign cysts), 51,00 (borderline), 73,37 (malignant cysts), 43,83 (metastasis). We found level of statistically significant differences P<0,001 between: benign cysts vs. TLL, borderline vs. TLL, TLL vs. malignant cysts, TLL vs. metastasis. We also found statistical difference between benign vs. malignant cysts (P=0,049), malignant cysts vs. metastasis (P=0,032).

Mean of tissue Ki-67(%): 3,22 (TLL), 1,41 (benign cysts), 4,71 (borderline), 37,00 (malignant cysts), 26,50 (metastasis). We found level of statistically significant differences P<0,001 between: benign vs. malignant cysts, benign cysts vs. metastasis, borderline vs. malignant cysts, borderline vs. metastasis, TLL vs. malignant cysts, TLL vs. metastasis. We also found statistical difference between benign cysts vs. borderline (P=0,019).

Conclusion Measurement of tissue HE4 enabled the differentiation between borderline vs. TLL, which could not be noticed by measurement of solely serum HE4. Determination of Ki-67 can discriminate benign and borderline ovarian disease. Our results present an argument for simultaneous determination of all above mentioned markers with the goal of clear differentiation between diverse histopathological entities.

Disclosures There are no conflicts of interest.