Evaluation of HE4 and TTR for diagnosis of ovarian cancer: Comparison with CA-125

Abstract Objective Serum human epididymis protein 4 (HE4) and transthyretin (TTR) are new markers for ovarian cancer. We compared HE4 and TTR with the gold marker CA-125 for the diagnosis of ovarian cancer patients. Methods One hundred and thirty serum samples from benign ovarian tumor and 400 serum samples from healthy women were used to set up the cut-off. One hundred and twenty-six serum samples from ovarian cancer patients before operation were collected to test the diagnostic value of these ELISA assays. The sensitivity, positive predictive value (PPV) and ROC curves were used to evaluate the diagnostic value. Results For CA-125, the sensitivity and PPV were respectively 64.29% and 53.57% for stage I–II cancer patients, and respectively 91.43% and 88.57% for stage III–IV cancer patients. For HE4, the sensitivity and PPV were respectively 46.4% and 43.3% for stage I–II cancer patients, and respectively 88.6% and 49.2% for stage III–IV cancer patients. For TTR, the sensitivity and PPV were respectively 78.6% and 68.8% for stage I–II cancer patients, and respectively 82.9% and 74.3% for stage III–IV cancer patients. For CA125, the ROC was respectively 0.7941 and 0.9520 for stage I–II patients and stage III–IV patients. For HE4, the diagnostic value of ROC was 0.7071 for stage I–II cancer patients and 0.9250 for stage III–IV cancer patients. For TTR, the diagnostic value of ROC was 0.9112 for stage I–II cancer patients and 0.9322 for stage III–IV cancer patients. Conclusion Our results support that TTR is an efficient serum marker for the diagnosis of early stage ovarian cancer patients.