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134 Covariate analysis of leukocytic HE-4 gene MRNA expression with clinical, histopathological, radiological and biochemical features in ovarian tumors: a North Indian study
  1. PP Roshnara,
  2. Smita Tripathi,
  3. Pikee Saxena and
  4. Rajeev Goyal
  1. Lady Hardinge Medical College, New Delhi, India


Introduction/Background Ovarian cancer is the 8th most common cancer and cause of cancer mortality. Tissue overexpression of the HE-4 (human epididymis-4) gene in ovarian cancer is well established. A low level of HE-4 expression is found in normal lymphocytes. There was positive correlations between the secretory leukocyte peptidase inhibitor (SLPI) as well as B lymphocytes with the overexpression of the HE-4 gene in serous ovarian cancer. According to the main goal of this investigation, this question is about whether the HE-4 gene might be upregulated in peripheral leukocytes in women with ovarian cancer.

Methodology A cross-sectional observational analytical study was conducted with 71 study participants. Leukocytic HE-4 gene mRNA (messenger ribonucleic acid) expression was analyzed using quantitative RT-PCR (real-time polymerase chain reaction) from fasting pre-operative blood samples. Ultrasonography was done using the iU22 ultrasound system (2–5 MHz probe). P-value<0.05 was taken as significant. Co-variate analysis was done based on the clinical, histopathological, radiological, and biochemical characteristics of the cases.

Results Leukocytic HE-4 mRNA expression, measured as an expression ratio with respect to a reference housekeeping gene, was significantly (p = 0.001) higher in malignant tumors (mean = 5.17±2.16) than in benign tumors (mean = 2.02±0.64). It had high diagnostic accuracy (84.5%) in the detection of malignancy, with 100% sensitivity and 81.4% specificity. It also showed a significant association with malignant features of ovarian tumors on trans-abdominal ultrasonography (p = 0.004) and histological subtypes of benign and malignant tumors (χ2 = 25.491, p = 0.001).

Conclusion Leukocytic HE-4 gene expression is a highly sensitive and specific biomarker for malignancy in ovarian tumors. A relatively non-invasive, economically viable, and high-risk screening methodology by RT-PCR can be devised with leukocytic HE-4 mRNA for ovarian tumors after conducting additional studies with a larger and more diverse sample size.

Disclosures None

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