Introduction
In the United Kingdom (UK) the first step in the ovarian cancer
diagnostic pathway for patients presenting to their General Practitioner
(GP) with relevant symptoms is to measure the CA125 in serum[1].
This process has a good positive predictive value to trigger the next
investigation, a pelvic ultrasound to identify a lesion. Measuring Human
Epididymis Protein 4 (HE4) identifies more accurately those pelvic
masses that are malignant[2], although this is not in current
routine use in the UK. The role of HE4 as a diagnostic test in primary
care has recently been evaluated[3]. HE4 performed well in patients
aged under 50. The possibility exists that measuring it alongside CA125
would improve the diagnostic performance of the standard pathway. We
sought to relate the HE4 results to clinical status in a group of
patients with elevated CA125 from whom clinical information was
available.