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Consideration should be given to smoking, endometriosis, renal function (eGFR) and age when interpreting CA125 and HE4 in ovarian tumor diagnostics
Department of Obstetrics and Gynecology, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg and Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.
University of Skövde, School of Bioscience. University of Skövde, Systems Biology Research Environment. (Translationell Bioinformatik, Translational Bioinformatics)ORCID iD: 0000-0001-9242-4852
Department of Obstetrics and Gynecology, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg and Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.
Department of Obstetrics and Gynecology, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg and Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.
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2021 (English)In: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 59, no 12, p. 1954-1962Article in journal (Refereed) Published
Abstract [en]

To evaluate the impact of different biologic, histopathologic and lifestyle factors on serum levels of human epididymis protein 4 (HE4) and Cancer antigen 125 (CA125) in the diagnostic work up of women with an ovarian cyst or pelvic tumor. The statistical evaluation was performed on a population of 445 women diagnosed with a benign ovarian disease, included in a large Swedish multicenter trial (ClinicalTrials.gov NCT03193671). Multivariable logistic regression analyses were performed to distinguish between the true negatives and false positives through adjusting for biologic, histopathologic and lifestyle factors on serum samples of CA125 and HE4 separately. The likelihood ratio test was used to determine statistical significance and Benjamini-Hochberg correction to adjust for multiple testing. A total of 31% of the women had false positive CA125 but only 9% had false positive results of HE4. Smoking (OR 6.62 95% CI 2.93-15.12) and impaired renal function, measured by eGFR (OR 0.18 95% CI 0.08-0.39), were independently predictive of falsely elevated serum levels of HE4. Endometriosis was the only variable predictive of falsely elevated serum levels of CA125 (OR 7.96 95% CI 4.53-14.39). Age correlated with increased serum levels of HE4. Smoking, renal failure, age and endometriosis are factors that independently should be considered when assessing serum levels of HE4 and CA125 in women with an ovarian cyst or pelvic mass to avoid false indications of malignant disease. 

Place, publisher, year, edition, pages
Walter de Gruyter, 2021. Vol. 59, no 12, p. 1954-1962
Keywords [en]
benign ovarian tumor, cancer antigen 125, diagnostics, endometriosis, human epididymis 4, renal failure, smoking
National Category
Cancer and Oncology Obstetrics, Gynecology and Reproductive Medicine
Research subject
Bioinformatics
Identifiers
URN: urn:nbn:se:his:diva-20540DOI: 10.1515/cclm-2021-0510ISI: 000724219800019PubMedID: 34388324Scopus ID: 2-s2.0-85113721277OAI: oai:DiVA.org:his-20540DiVA, id: diva2:1592465
Funder
Swedish Cancer Society
Note

CC BY 4.0

© 2021

Pre-published online by De Gruyter August 12, 2021

The study was funded by the Swedish Cancer Foundation (KS), LUA-ALF (KS), the Assar Gabrielsson Foundation (ML, BK, CM), the Hjalmar Svensson Foundation (ML), and the Gothenburg Medical Society (ML). Roche Diagnostics Scandinavia covered the cost of running biomarker assays at the accredited laboratory at Sahlgrenska University Hospital, Gothenburg, Sweden. The funding organizations played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

Available from: 2021-09-09 Created: 2021-09-09 Last updated: 2022-04-20Bibliographically approved

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Ulfenborg, Benjamin

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