Objectives: We aimed to analyze and evaluate the diagnostic value of serum human epididymis protein 4 (HE4) in ovarian cancer (OC) of patients with different menopausal status.
Material and methods: A comprehensive electronic and manual search of the relevant literature was performed through several databases such as CNKI, Wanfang database, VIP database, Chinese biomedical database, web of science, PubMed, EMBASE, and Cochrane database. We collected Chinese and English articles to assess the diagnostic value of HE4 for ovarian cancer in female with different menopausal status. The quality of the studies included in the systematic review was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool.
Results: A total of 14 publications were included in this study and we didn't find publication bias in them. The sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of HE4 for the diagnosis of ovarian cancer in postmenopausal vs. premenopausal female were 0.71 (95% CI, 0.63-0.78) vs 0.78 (95% CI, 0.74-0.81); 0.91 (95% CI, 0.85-0.95) vs 0.90 (95% CI, 0.86-0.93); 11.90 (95% CI, 6.42-22.07) vs 11.03 (95% CI, 6.44-18.89); and 0.30 (95% CI, 0.22-0.39) vs 0.24 (95% CI, 0.20-0.29), respectively.
Conclusions: Serum HE4 has greater diagnostic value in detecting ovarian cancer, especially in Asian postmenopausal female.
Keywords: HE4; diagnosis; meta-analysis; ovarian cancer; tumor markers.