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Abstract
Introduction/Background Extensive scientific literature has documented the well-established phenomenon of tissue overexpression of the HE-4 (human epididymis-4) gene in ovarian cancer. A low level of HE-4 gene expression is seen in lymphocytes. Determining whether or not the HE-4 gene is expressed in leukocytes of women without ovarian mass and, if so, whether or not it correlates with menstrual or obstetric characteristics, thereby becoming confounding variables, was the primary objective of this study.
Methodology A cross-sectional observational-analytical study was conducted with 36 healthy women. 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. Collinearity diagnostics was done using SPSS version 25, and a tolerance level >0.4 was considered significant.
Results Mean age of the women included in the study were 37.53 ± 13.21 years. Mean leukocytic HE-4 gene mRNA expression, measured as expression ratio with respect to a reference gene expression was 1.03±0.27. Variables that had significant (p<0.05) correlation were age (rho = -0.56) and serum CA-125 (rho = 1). Significantly (p<0.05) higher mRNA levels were associated with menopausal status (0.82 ± 0.27 in post-menopause v/s 1.14 ± 0.21 in pre-menopause), dysmenorrhea (1.09 ± 0.18 v/s 1.30 ± 0.23) and sexual activity (1.18 ± 0.25 vs 0.96 ± 0.26). By collinearity diagnostics, the highest tolerance level was seen for serum CA-125 levels.
Conclusion Leukocytes express the HE-4 gene in women without ovarian tumors. The mRNA levels of the HE-4 gene in leukocytes are high in sexually active, pre-menopausal women with regular menstruation and dysmenorrhea. When evaluating the leukocytic HE-4 gene mRNA expression, it is imperative to take into account these factors as potential confounders or sources of bias.
Disclosures None
