Falsely elevated human epididymis protein 4 results and Risk of Ovarian Malignancy Algorithm in polymorbid women after solid organ transplantation: A pilot and case-control study
Abstrakt
BackgroundCancer prevention is essential after transplantation (Tx). The use of HE4 and Risk of Ovarian Malignancy Algorithm (ROMA) is recommended as a tool for selective ovarian cancer screening; however, creatinine is a known confounder.
This study assessed the reliability of HE4, CA125, and ROMA after Tx. MethodsWe matched a total of 202 women without gynecological malignancies and 236 men by age and serum creatinine.
Each pair consisted of a patient after Tx (kidney, liver, heart, and pancreas) and a diseased but non-Tx consecutive patient. Serum HE4, CA125 (Roche Cobas 6000), and creatinine (enzymatic, Abbott Architect) were measured in all patients.
ResultsCreatinine correlated with HE4 (women: r=.864, P<.0001; men: r=.848, P<.0001). Age correlated slightly with HE4 in women (r=.250, P<.005) and men (r=.240, P<.0005).
HE4 in women after Tx (median of 84.8pmol/L) was significantly higher than non-Tx women (53.7pmol/L, P<.0001) in the reference range of serum creatinine. Neither HE4 nor CA125 correlated with tacrolimus concentration, but anemia, hyperparathyroidism, kidney, liver, and lung diseases were possible confounders for HE4 after transplantation (P<.05).
ConclusionHuman epididymis protein 4 (HE4) was significantly increased in women after solid organ transplantation compared to levels without transplants matched by age and serum creatinine. HE4 results may be misleading in these patients.