PT  - JOURNAL ARTICLE
AU  - Macedo, Ana Cristina Lacerda
AU  - da Rosa, Maria Inês
AU  - Lumertz, Suéli
AU  - Medeiros, Lidia Rosi
TI  - Accuracy of Serum Human Epididymis Protein 4 in Ovarian Cancer Diagnosis: A Systematic Review and Meta-Analysis
AID  - 10.1097/IGC.0000000000000192
DP  - 2014 Sep 01
TA  - International Journal of Gynecologic Cancer
PG  - 1222--1231
VI  - 24
IP  - 7
4099  - http://ijgc.bmj.com/content/24/7/1222.short
4100  - http://ijgc.bmj.com/content/24/7/1222.full
SO  - Int J Gynecol Cancer2014 Sep 01; 24
AB  - Objective A systematic review was performed to estimate the accuracy of human epididymis protein 4 (HE4) assay in the diagnosis of ovarian tumors.Methods A comprehensive search of the MEDLINE (PubMed), EMBASE, Cochrane Central Register of Controlled Trials, IBECS, BIOSIS, Web of Science, SCOPUS, congress abstracts, and Grey literature (Google scholar; British Library) from January 1990 to April 2013 was conducted. Studies that evaluated HE4 levels for the diagnosis of ovarian tumors and compared them with paraffin-embedded sections as the diagnostic standard were included.Results Forty-five studies were analyzed, which included 10,671 women and 3946 ovarian cancer cases. The pooled sensitivity for the diagnosis of borderline tumors or ovarian cancer was 78% (95% confidence interval, 77%–79%), and the specificity was 86% (95% confidence interval, 85%–87%). Summary receiver operating characteristic curves were constructed. For malignant and borderline ovarian tumors versus benign lesions, the area under the curve was 0.916. Besides the overall analysis, stratification was performed in premenopause and postmenopause, early and late stages, and for accuracy by enzyme-linked immunosorbent assay and chemiluminescence microparticle immuno assay.Conclusions A HE4 level is a useful preoperative test for predicting the benign or malignant nature of pelvic masses.