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Can serum human epididymis protein 4 (HE4) support the decision to refer a patient with an ovarian mass to an oncology hospital? / Lof, P.; van de Vrie, R.; Korse, C. M. et al.

In: Gynecologic oncology, Vol. 166, No. 2, 08.2022, p. 284-291.

Research output: Contribution to journalArticleAcademicpeer-review

Harvard

Lof, P, van de Vrie, R, Korse, CM, van Gent, MDJM, Mom, CH, Rosier - van Dunné, FMF, van Baal, WM, Verhoeve, HR, Hermsen, BBJ, Verbruggen, MB, Hemelaar, M, van de Swaluw, AMG, Knipscheer, HC, Huirne, JAF, Westenberg, SM, van der Noort, V, Amant, F, van den Broek, D & Lok, CAR 2022, 'Can serum human epididymis protein 4 (HE4) support the decision to refer a patient with an ovarian mass to an oncology hospital?', Gynecologic oncology, vol. 166, no. 2, pp. 284-291. https://doi.org/10.1016/j.ygyno.2022.05.025

APA

Lof, P., van de Vrie, R., Korse, C. M., van Gent, M. D. J. M., Mom, C. H., Rosier - van Dunné, F. M. F., van Baal, W. M., Verhoeve, H. R., Hermsen, B. B. J., Verbruggen, M. B., Hemelaar, M., van de Swaluw, A. M. G., Knipscheer, H. C., Huirne, J. A. F., Westenberg, S. M., van der Noort, V., Amant, F., van den Broek, D., & Lok, C. A. R. (2022). Can serum human epididymis protein 4 (HE4) support the decision to refer a patient with an ovarian mass to an oncology hospital? Gynecologic oncology, 166(2), 284-291. https://doi.org/10.1016/j.ygyno.2022.05.025

Vancouver

Lof P, van de Vrie R, Korse CM, van Gent MDJM, Mom CH, Rosier - van Dunné FMF et al. Can serum human epididymis protein 4 (HE4) support the decision to refer a patient with an ovarian mass to an oncology hospital? Gynecologic oncology. 2022 Aug;166(2):284-291. Epub 2022. doi: 10.1016/j.ygyno.2022.05.025

Author

BibTeX

@article{96633610562f4737a937774819dbd891,
title = "Can serum human epididymis protein 4 (HE4) support the decision to refer a patient with an ovarian mass to an oncology hospital?",
abstract = "Introduction: The value of serum human epididymis protein 4 (HE4) in guiding referral decisions in patients with an ovarian mass remains unclear, because the majority of studies investigating HE4 were performed in oncology hospitals. However, the decision to refer is made at general hospitals with a low ovarian cancer prevalence. We assessed accuracies of HE4 in differentiating benign or borderline from malignant tumors in patients presenting with an ovarian mass at general hospitals. Method: Patients with an ovarian mass were prospectively included between 2017 and 2021 in nine general hospitals. HE4 and CA125 were preoperatively measured and the risk of malignancy index (RMI) was calculated. Histological diagnosis was the reference standard. Results: We included 316 patients, of whom 195 had a benign, 39 had a borderline and 82 had a malignant ovarian mass. HE4 had the highest AUC of 0.80 (95%CI 0.74–0.86), followed by RMI (0.71, 95%CI 0.64–0.78) and CA125 (0.69, 95%CI 0.62–0.75). Clinical setting significantly influenced biomarker performances. Applying age-dependent cut-off values for HE4 resulted in a better performance than one cut-off. Addition of HE4 to RMI resulted in a 32% decrease of unnecessary referred patients, while the number of correctly referred patients remained the same. Conclusion: HE4 is superior to RMI in predicting malignancy in patients with an ovarian mass from general hospitals. The addition of HE4 to the RMI improved HE4 alone. Although, there is still room for improvement, HE4 can guide referral decisions in patients with an ovarian mass to an oncology hospital.",
keywords = "HE4, Ovarian mass, RMI",
author = "P. Lof and {van de Vrie}, R. and Korse, {C. M.} and {van Gent}, {M. D. J. M.} and Mom, {C. H.} and {Rosier - van Dunn{\'e}}, {F. M. F.} and {van Baal}, {W. M.} and Verhoeve, {H. R.} and Hermsen, {B. B. J.} and Verbruggen, {M. B.} and M. Hemelaar and {van de Swaluw}, {A. M. G.} and Knipscheer, {H. C.} and Huirne, {J. A. F.} and Westenberg, {S. M.} and {van der Noort}, V. and F. Amant and {van den Broek}, D. and Lok, {C. A. R.}",
note = "Funding Information: Funding of this project was provided by Stichting Hanarth Fonds. Publisher Copyright: {\textcopyright} 2022 Elsevier Inc.",
year = "2022",
month = aug,
doi = "10.1016/j.ygyno.2022.05.025",
language = "English",
volume = "166",
pages = "284--291",
journal = "Gynecologic oncology",
issn = "0090-8258",
publisher = "Academic Press Inc.",
number = "2",

}

RIS

TY - JOUR

T1 - Can serum human epididymis protein 4 (HE4) support the decision to refer a patient with an ovarian mass to an oncology hospital?

AU - Lof, P.

AU - van de Vrie, R.

AU - Korse, C. M.

AU - van Gent, M. D. J. M.

AU - Mom, C. H.

AU - Rosier - van Dunné, F. M. F.

AU - van Baal, W. M.

AU - Verhoeve, H. R.

AU - Hermsen, B. B. J.

AU - Verbruggen, M. B.

AU - Hemelaar, M.

AU - van de Swaluw, A. M. G.

AU - Knipscheer, H. C.

AU - Huirne, J. A. F.

AU - Westenberg, S. M.

AU - van der Noort, V.

AU - Amant, F.

AU - van den Broek, D.

AU - Lok, C. A. R.

N1 - Funding Information: Funding of this project was provided by Stichting Hanarth Fonds. Publisher Copyright: © 2022 Elsevier Inc.

PY - 2022/8

Y1 - 2022/8

N2 - Introduction: The value of serum human epididymis protein 4 (HE4) in guiding referral decisions in patients with an ovarian mass remains unclear, because the majority of studies investigating HE4 were performed in oncology hospitals. However, the decision to refer is made at general hospitals with a low ovarian cancer prevalence. We assessed accuracies of HE4 in differentiating benign or borderline from malignant tumors in patients presenting with an ovarian mass at general hospitals. Method: Patients with an ovarian mass were prospectively included between 2017 and 2021 in nine general hospitals. HE4 and CA125 were preoperatively measured and the risk of malignancy index (RMI) was calculated. Histological diagnosis was the reference standard. Results: We included 316 patients, of whom 195 had a benign, 39 had a borderline and 82 had a malignant ovarian mass. HE4 had the highest AUC of 0.80 (95%CI 0.74–0.86), followed by RMI (0.71, 95%CI 0.64–0.78) and CA125 (0.69, 95%CI 0.62–0.75). Clinical setting significantly influenced biomarker performances. Applying age-dependent cut-off values for HE4 resulted in a better performance than one cut-off. Addition of HE4 to RMI resulted in a 32% decrease of unnecessary referred patients, while the number of correctly referred patients remained the same. Conclusion: HE4 is superior to RMI in predicting malignancy in patients with an ovarian mass from general hospitals. The addition of HE4 to the RMI improved HE4 alone. Although, there is still room for improvement, HE4 can guide referral decisions in patients with an ovarian mass to an oncology hospital.

AB - Introduction: The value of serum human epididymis protein 4 (HE4) in guiding referral decisions in patients with an ovarian mass remains unclear, because the majority of studies investigating HE4 were performed in oncology hospitals. However, the decision to refer is made at general hospitals with a low ovarian cancer prevalence. We assessed accuracies of HE4 in differentiating benign or borderline from malignant tumors in patients presenting with an ovarian mass at general hospitals. Method: Patients with an ovarian mass were prospectively included between 2017 and 2021 in nine general hospitals. HE4 and CA125 were preoperatively measured and the risk of malignancy index (RMI) was calculated. Histological diagnosis was the reference standard. Results: We included 316 patients, of whom 195 had a benign, 39 had a borderline and 82 had a malignant ovarian mass. HE4 had the highest AUC of 0.80 (95%CI 0.74–0.86), followed by RMI (0.71, 95%CI 0.64–0.78) and CA125 (0.69, 95%CI 0.62–0.75). Clinical setting significantly influenced biomarker performances. Applying age-dependent cut-off values for HE4 resulted in a better performance than one cut-off. Addition of HE4 to RMI resulted in a 32% decrease of unnecessary referred patients, while the number of correctly referred patients remained the same. Conclusion: HE4 is superior to RMI in predicting malignancy in patients with an ovarian mass from general hospitals. The addition of HE4 to the RMI improved HE4 alone. Although, there is still room for improvement, HE4 can guide referral decisions in patients with an ovarian mass to an oncology hospital.

KW - HE4

KW - Ovarian mass

KW - RMI

UR - http://www.scopus.com/inward/record.url?scp=85131789398&partnerID=8YFLogxK

U2 - 10.1016/j.ygyno.2022.05.025

DO - 10.1016/j.ygyno.2022.05.025

M3 - Article

C2 - 35688656

VL - 166

SP - 284

EP - 291

JO - Gynecologic oncology

JF - Gynecologic oncology

SN - 0090-8258

IS - 2

ER -

ID: 24374061