AIM: An optimal surgical staging in the group of patients with the high-risk type of endometrial cancer is often limited by age and serious internal comorbidities. Therefore, in this study we focused on human epididymis protein 4 and its contribution to the preoperative differentiation of prognostically distinct groups of patients and to individualized surgical treatment as compared with cancer antigen (CA) 125 and imaging methods. MATERIAL AND METHODS: The study included 115 patients with endometrioid adenocarcinoma diagnosed through endometrial biopsy. Before the final operation, blood sampling was performed for the determination of human epididymis protein 4 (HE4) and CA125 levels. Serum levels of both biomarkers were analyzed in relation to individual prognostic factors (stage of disease, depth of myometrial invasion, tumor grade, risk type of disease). RESULTS: In the case of HE4, we demonstrated a statistically significant difference (P < 0.001) between patients with low and high risk of the disease. In our model, achieving the maximum sum of sensitivity and specificity, HE4 shows a sensitivity of 72.4% and a specificity of 75.4% for the cut-off 76.5 pmol/L and is a better predictor in distinguishing the high-risk patients than CA125 (area under the curve 0.77 for HE vs 0.71 for CA125). CONCLUSION: HE4 is a marker that could complement the findings of imaging techniques and that may be useful in decision-making on how to individualize surgical staging. The possibility of its introduction as an independent marker in routine practice remains, at the moment however, limited. The optimal cut-off for HE4 has not been established yet and further studies are needed.

• MeSH
• antigen CA-125 krev   MeSH
• endometroidní karcinom krev   patologie   MeSH
• lidé MeSH
• membránové proteiny krev   MeSH
• myometrium patologie   MeSH
• nádorové biomarkery krev   MeSH
• nádory endometria krev   patologie   MeSH
• proteiny metabolismus   MeSH
• staging nádorů MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: We have recently shown that human epididymis protein 4 (HE4) levels correlate with the severity of cystic fibrosis (CF) lung disease. However, there are no data on how HE4 levels alter in patients receiving CFTR modulating therapy. METHODS: In this retrospective clinical study, 3 independent CF patient cohorts (US-American: 29, Australian: 12 and Irish: 19 cases) were enrolled carrying at least one Class III CFTR CF-causing mutation (p.Gly551Asp) and being treated with CFTR potentiator ivacaftor. Plasma HE4 was measured by immunoassay before treatment (baseline) and 1-6 months after commencement of ivacaftor, and were correlated with FEV1 (% predicted), sweat chloride, C-reactive protein (CRP) and body mass index (BMI). RESULTS: After 1 month of therapy, HE4 levels were significantly lower than at baseline and remained decreased up to 6 months. A significant inverse correlation between absolute and delta values of HE4 and FEV1 (r = -0.5376; P < .001 and r = -0.3285; P < .001), was retrospectively observed in pooled groups, including an independent association of HE4 with FEV1 by multiple regression analysis (β = -0.57, P = .019). Substantial area under the receiver operating characteristic curve (ROC-AUC) value was determined for HE4 when 7% mean change of FEV1 (0.722 [95% CI 0.581-0.863]; P = .029) were used as classifier, especially in the first 2 months of treatment (0.806 [95% CI 0.665-0.947]; P < .001). CONCLUSIONS: This study shows that plasma HE4 levels inversely correlate with lung function improvement in CF patients receiving ivacaftor. Overall, this potential biomarker may be of value for routine clinical and laboratory follow-up of CFTR modulating therapy.

• MeSH
• aktivátory chloridových kanálů terapeutické užití   MeSH
• aminofenoly terapeutické užití   MeSH
• biologické markery analýza   MeSH
• chinolony terapeutické užití   MeSH
• cystická fibróza * genetika   patofyziologie   terapie   MeSH
• dítě MeSH
• dospělí MeSH
• index tělesné hmotnosti MeSH
• lidé MeSH
• monitorování léčiv metody   MeSH
• mutace MeSH
• pot chemie   MeSH
• protein CFTR genetika   MeSH
• protein WFDC2 analýza   MeSH
• respirační funkční testy metody   MeSH
• retrospektivní studie MeSH
• usilovný výdechový objem účinky léků   MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinická studie MeSH
• práce podpořená grantem MeSH

BACKGROUND: Increased expression of the human epididymis protein 4 (HE4) was previously described in lung biopsy samples from patients with cystic fibrosis (CF). It remains unknown, however, whether serum HE4 concentrations are elevated in CF. METHODS: Seventy-seven children with CF from six Hungarian CF centers and 57 adult patients with CF from a Czech center were enrolled. In addition, 94 individuals with non-CF lung diseases and 117 normal control subjects with no pulmonary disorders were analyzed. Serum HE4 levels were measured by using an immunoassay, and their expression was further investigated via the quantification of HE4 messenger RNA by using quantitative reverse transcription polymerase chain reaction in CF vs non-CF respiratory epithelium biopsy specimens. The expression of the potential regulator miR-140-5p was analyzed by using an UPL-based quantitative reverse transcription polymerase chain reaction assay. HE4 was measured in the supernatants from unpolarized and polarized cystic fibrosis bronchial epithelial cells expressing wild-type or F508del-CFTR. RESULTS: Median serum HE4 levels were significantly elevated in children with CF (99.5 [73.1-128.9] pmol/L) compared with control subjects (36.3 [31.1-43.4] pmol/L; P < .0001). This observation was replicated in adults with CF (115.7 [77.8-148.7] pmol/L; P < .0001). In contrast, abnormal but lower HE4 concentrations were found in cases of severe bronchitis, asthma, pneumonia, and bronchiectasis. In patients with CF, the concentrations of HE4 were positively correlated with overall disease severity and C-reactive protein concentrations, whereas a significant inverse relationship was found between HE4 and the spirometric FEV1 value. Relative HE4 mRNA levels were significantly upregulated (P = .011) with a decreased miR-140-5p expression (P = .020) in the CF vs non-CF airway biopsy specimens. Twofold higher HE4 concentrations were recorded in the supernatant of polarized F508del-CF transmembrane conductance regulator/bronchial epithelial cells compared with wild-type cells. CONCLUSIONS: HE4 serum levels positively correlate with the overall severity of CF and the degree of pulmonary dysfunction. HE4 may thus be used as a novel inflammatory biomarker and possibly also as a measure of treatment efficacy in CF lung disease.

• MeSH
• bronchiální astma genetika   metabolismus   MeSH
• bronchiektazie genetika   metabolismus   MeSH
• bronchitida genetika   metabolismus   MeSH
• C-reaktivní protein metabolismus   MeSH
• cystická fibróza genetika   metabolismus   patofyziologie   MeSH
• dítě MeSH
• dospělí MeSH
• epitelové buňky metabolismus   MeSH
• lidé MeSH
• messenger RNA metabolismus   MeSH
• mikro RNA metabolismus   MeSH
• mladiství MeSH
• mladý dospělý MeSH
• pneumonie genetika   metabolismus   MeSH
• polymerázová řetězová reakce s reverzní transkripcí MeSH
• předškolní dítě MeSH
• protein CFTR genetika   MeSH
• proteiny genetika   metabolismus   MeSH
• respirační sliznice metabolismus   MeSH
• spirometrie MeSH
• studie případů a kontrol MeSH
• stupeň závažnosti nemoci MeSH
• usilovný výdechový objem MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Úvod: Melanóm je jedným z najmalígnejších nádorov kože a je najčastejšou príčinou úmrtia u kožných ochorení. V ostatných desaťročiach sa jeho výskyt výrazne zvýšil. Cieľom našej práce bolo porovnať hladinu onkomarkera ľudský epididymálny proteín 4 (HE4) v korelácii s nálezom kostných metastáz zistených pri celotelovej scintigrafii skeletu u pacientov s malígnym melanómom a posúdiť jeho význam v diagnostike malígneho melanómu. Materiál a metódy: U 14 pacientov (4 muži, 10 žien) s malígnym melanómom sme stanovili hladinu HE4 v sére z krvnej vzorky odobratej pred aplikáciou rádiofarmaka v rámci vyšetrenia celotelovej scintigrafie skeletu za použitia hybridnej gamakamery SPECT/CT (single photon emission computed tomography/computed tomography, jednofotónová emisná počítačová tomografia/počítačová tomografia). Výsledky sme porovnali s hodnotami 10 ľudí bez prítomného nádorového ochorenia, ktorí tvorili kontrolnú skupinu. Výsledky: Kostné metastázy zistené pri celotelovej scintigrafii skeletu boli prítomné v 5 prípadoch (35,71 %), pravdepodobné v 3 prípadoch (21,43 %) a 6 pacienti (42,86 %) boli bez nálezu kostných metastáz. Koncentrácia HE4 bola u pacientov signifikantne vyššia ako u kontrolnej skupiny. Nad rozsah referenčných hodnôt bola koncentrácia HE4 zvýšená len u jedného pacienta s melanómom. Koncentrácie HE4 sa u pacientov nelíšili v závislosti od kostných metastáz. Záver: V našej pilotnej štúdii sme u pacientov s malígnym melanómom pozorovali vyššie koncentrácie HE4 v porovnaní s kontrolnou skupinou. Sérové hladiny HE4 nekorelovali s nálezom pri celotelovej scintigrafii skeletu.

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• MeSH
• dospělí MeSH
• epididymální sekreční proteiny diagnostické užití   MeSH
• jednofotonová emisní výpočetní tomografie * MeSH
• lidé středního věku MeSH
• lidé MeSH
• melanom * krev   MeSH
• metastázy nádorů * MeSH
• nádorové biomarkery * krev   MeSH
• nádory kostí epidemiologie   sekundární   MeSH
• pilotní projekty MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH

BACKGROUND: We previously documented that elevated HE4 plasma concentration decreased in people with CF (pwCF) bearing the p.Gly551Asp-CFTR variant in response to CFTR modulator (CFTRm) ivacaftor (IVA), and this level was inversely correlated with the FEV1% predicted values (ppFEV1). Although the effectiveness of lumacaftor (LUM)/IVA in pwCF homozygous for the p.Phe508del-CFTR variant has been evaluated, plasma biomarkers were not used to monitor treatment efficacy thus far. METHODS: Plasma HE4 concentration was examined in 68 pwCF drawn from the PROSPECT study who were homozygous for the p.Phe508del-CFTR variant before treatment and at 1, 3, 6 and 12 months after administration of LUM/IVA therapy. Plasma HE4 was correlated with ppFEV1 using their absolute and delta values. The discriminatory power of delta HE4 was evaluated for the detection of lung function improvements based on ROC-AUC analysis and multiple regression test. RESULTS: HE4 plasma concentration was significantly reduced below baseline following LUM/IVA administration during the entire study period. The mean change of ppFEV1 was 2.6% (95% CI, 0.6 to 4.5) by 6 months of therapy in this sub-cohort. A significant inverse correlation between delta values of HE4 and ppFEV1 was observed especially in children with CF (r=-0.7053; p<0.0001). Delta HE4 predicted a 2.6% mean change in ppFEV1 (AUC: 0.7898 [95% CI 0.6823-0.8972]; P < 0.0001) at a cut-off value of -10.7 pmol/L. Moreover, delta HE4 independently represented the likelihood of being a responder with ≥ 5% delta ppFEV1 at 6 months (OR: 0.89, 95% CI: 0.82-0.95; P = 0.001). CONCLUSIONS: Plasma HE4 level negatively correlates with lung function improvement assessed by ppFEV1 in pwCF undergoing LUM/IVA CFTRm treatment.

• MeSH
• aktivátory chloridových kanálů terapeutické užití   MeSH
• aminofenoly terapeutické užití   MeSH
• aminopyridiny terapeutické užití   MeSH
• benzodioxoly terapeutické užití   MeSH
• cystická fibróza * diagnóza   farmakoterapie   genetika   MeSH
• dítě MeSH
• fixní kombinace léků MeSH
• homozygot MeSH
• lidé MeSH
• mutace MeSH
• protein CFTR genetika   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Decreased human epididymis protein 4 (HE4) plasma levels were reported in cystic fibrosis (CF) patients under CFTR potentiator ivacaftor therapy, which inversely correlated with lung function improvement. In this study, we investigated whether HE4 expression was affected via modulation of CFTR function in CF bronchial epithelial (CFBE) cells in vitro. HE4 protein levels were measured in the supernatants of CFBE 41o- cells expressing F508del-CFTR or wild-type CFTR (wt-CFTR) after administration of lumacaftor/ivacaftor or tezacaftor/ivacaftor, while HE4 expression in CFBE 41o- cells were also analyzed following application of adenylate cyclase activators Forskolin/IBMX or CFTRinh172. The effect of all of these compounds on CFTR function was monitored by the whole-cell patch-clamp technique. Induced HE4 expression was studied with interleukin-6 (IL-6) in F508del-CFTR CFBE 41o- cells under TNF-α stimulation for 1 h up to 1 week in duration. In parallel, plasma HE4 was determined in CF subjects homozygous for p.Phe508del-CFTR mutation receiving lumacaftor/ivacaftor (Orkambi®) therapy. NF-κB-mediated signaling was observed via the nuclear translocation of p65 subunit by fluorescence microscopy together with the analysis of IL-6 expression by an immunoassay. In addition, HE4 expression was examined after NF-κB pathway inhibitor BAY 11-7082 treatment with or without CFTR modulators. CFTR modulators partially restored the activity of F508del-CFTR and reduced HE4 concentration was found in F508del-CFTR CFBE 41o- cells that was close to what we observed in CFBE 41o- cells with wt-CFTR. These data were in agreement with decreased plasma HE4 concentrations in CF patients treated with Orkambi®. Furthermore, CFTR inhibitor induced elevated HE4 levels, while CFTR activator Forskolin/IBMX downregulated HE4 in the cell cultures and these effects were more pronounced in the presence of CFTR modulators. Higher activation level of baseline and TNF-α stimulated NF-κB pathway was detected in F508del-CFTR vs. wt-CFTR CFBE 41o- cells that was substantially reduced by CFTR modulators based on lower p65 nuclear positivity and IL-6 levels. Finally, HE4 expression was upregulated by TNF-α with elevated IL-6, and both protein levels were suppressed by combined administration of NF-κB pathway inhibitor and CFTR modulators in CFBE 41o- cells. In conclusion, CFTR dysfunction contributes to abnormal HE4 expression via NF-κB in CF.

• Publikační typ
• časopisecké články MeSH

A novel enzyme-free electrochemical immunosensor was developed for highly sensitive detection and quantification of human epididymis protein 4 (HE4) in human serum. For the first time, core/shell CdSe/ZnS quantum dots were conjugated with anti-HE4 IgG antibodies for subsequent sandwich-type immunosensing with superparamagnetic microparticles functionalized with anti-HE4 IgG antibodies, which allow rapid and efficient HE4 capture from the sample. Electrochemical detection of anti-HE4 IgG - HE4 - anti-HE4 IgGCdSe/ZnS immunocomplex was performed by recording the current response of Cd(II) ions, released from dissolved quantum dots at screen-printed carbon electrode (SPCE), modified with mercury or bismuth film. The linear range of the detection was from 20 pM to 40 nM with limit of detection of 12 pM using three times the standard deviation of blank criterion at mercury-film SPCE and from 100 pM to 2 nM with limit of detection of 89 pM at bismuth-film SPCE. Proposed electrochemical immunosensor meets the requirements for fast and sensitive quantification of HE4 biomarker in early stage of ovarian cancer and due to the proper sensitivity and specificity presents a promising alternative to enzyme-based probes used routinely in clinical diagnostics.

• MeSH
• biosenzitivní techniky * MeSH
• bismut chemie   MeSH
• časná detekce nádoru MeSH
• elektrochemické techniky * MeSH
• elektrody MeSH
• exprese genu MeSH
• imunoanalýza * MeSH
• imunokonjugáty chemie   metabolismus   MeSH
• kvantové tečky chemie   MeSH
• lidé MeSH
• nádorové biomarkery krev   genetika   MeSH
• nádory vaječníků krev   diagnóza   genetika   patologie   MeSH
• proteiny analýza   genetika   metabolismus   MeSH
• protilátky chemie   metabolismus   MeSH
• rtuť chemie   MeSH
• sloučeniny kadmia chemie   MeSH
• sloučeniny selenu chemie   MeSH
• sloučeniny zinku chemie   MeSH
• uhlík chemie   MeSH
• vazba proteinů MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

The hypodactylous (hd) locus impairs limb development and spermatogenesis, leading to male infertility in rats. We show that the hd mutation is caused by an insertion of an endogenous retrovirus into intron 10 of the Cntrob gene. The retroviral insertion in hd mutant rats disrupts the normal splicing of Cntrob transcripts and results in the expression of a truncated protein. During the final phase of spermiogenesis, centrobin localizes to the manchette, centrosome, and the marginal ring of the spermatid acroplaxome, where it interacts with keratin 5-containing intermediate filaments. Mutant spermatids show a defective acroplaxome marginal ring and separation of the centrosome from its normal attachment site of the nucleus. This separation correlates with a disruption of head-tail coupling apparatus, leading to spermatid decapitation during the final step of spermiogenesis and the absence of sperm in the epididymis. Cntrob may represent a novel candidate gene for presently unexplained hereditary forms of teratozoospermia and the "easily decapitated sperm syndrome" in humans.

• MeSH
• bičík spermie metabolismus   MeSH
• blotting far-western MeSH
• centrozom metabolismus   MeSH
• elektronová mikroskopie MeSH
• endogenní retroviry genetika   MeSH
• epididymis metabolismus   MeSH
• fluorescenční protilátková technika MeSH
• hlavička spermie metabolismus   MeSH
• homeoboxové geny genetika   MeSH
• homeodoménové proteiny metabolismus   MeSH
• introny genetika   MeSH
• keratin-5 genetika   metabolismus   MeSH
• krysa rodu rattus MeSH
• mutace genetika   MeSH
• mužská infertilita genetika   metabolismus   MeSH
• polymerázová řetězová reakce s reverzní transkripcí MeSH
• proteiny buněčného cyklu fyziologie   MeSH
• spermatidy metabolismus   MeSH
• spermatogeneze genetika   MeSH
• transport proteinů genetika   MeSH
• zvířata MeSH
• Check Tag
• krysa rodu rattus MeSH
• mužské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• práce podpořená grantem MeSH

Cíl studie: Cílem studie bylo zhodnotit využití lidského epididymálního proteinu 4 (HE4) v diferenciální diagnostice biologické povahy patologií endometria při současném srovnání s konvenčním nádorovým antigenem 125 (CA 125) v populaci českých žen. Typ studie: Původní práce. Název a sídlo pracoviště: Gynekologicko-porodnická klinika klinika LF MU a FN Brno. Metodika: Do naší prospektivní studie bylo v období 7/2010 – 6/2013 zařazeno 115 pacientek s endometroidním adenokarcinomem endometria a 106 pacientek v kontrolním souboru s benigní lézí endometria. Histologický nález byl získán vyšetřením biopsie endometria. U všech pacientek byla po bioptické verifikaci stanovena sérová hladina HE4 a CA 125 a pacientky s malignitou byly indikovány k chirurgickému stagingu k určení stadia nemoci. Medián a rozsahy sérových hladin obou biomarkerů byly analyzovány ve vztahu k biologické povaze nemoci. Statistická analýza pracuje s logaritmovanými hodnotami stanovených markerů vzhledem k tomu, že HE4 a CA 125 v obou souborech nevykazují normální rozdělení a využívá logistické regrese. Výsledky: Při analýze dvou souborů biologicky odlišné povahy byl prokázán vysoce signifikantní rozdíl (p < 0,05) pouze v případě HE4, při cut-off48,5 pmol/l bylo dosaženo senzitivity 87,8 %, specificity 56,6 % a negativní prediktivní hodnoty 81,1 %. Závěr: Diagnostický přínos biomarkeru HE4 lze zvažovat zejména v kohortě pacientek se zvýšeným rizikem karcinomu endometria a u pacientek výrazně interně kompromitovaných s limitací operačního výkonu. Tento marker by tedy mohl v kombinaci s ultrazvukovým vyšetřením pomoci v diferenciaci prognosticky odlišných skupin pacientek a v individualizaci léčebného postupu. Nevyřešená však zůstává otázka optimálního cut-off, k čemuž by měly přispět výsledky dalších rozsáhlejších studií a jejich komparativní analýza.

Objective: The aim of the present study was to evaluate the use of human epididymis protein 4 (HE4) and cancer antigen 125 (CA 125) biomarkers in differential diagnosis of malignant and benign endometrial tumours in a population of Czech women. Design: Prospective study. Setting: Department of Gynaecology and Obstetrics, Faculty of Medicine at Masaryk University and Faculty Hospital in Brno. Methods: Our prospective study includes 115 patients with endometrioid adenocarcinoma and 106 patients with benign endometrial tumours in the control group. They were diagnosed with endometrial biopsy in the period from 7/2010 to 6/2013. The patients with cancer underwent definitive surgical treatment to determine the stage of disease. The median and ranges of serum levels were determined in relation to the histological result (benign vs malignant disease). Statistical analysis operates with logarithm values of markers because their distribution is not normal and uses logistic regression. Results: While analysing two groups of patients with different histology, there was demonstrated a statistically significant difference (p < 0.05), only in HE4, by cut-off 48,5 pmol/l there was achieved sensitivity of 87.8%, specificity of 56.6% and negative predictive value of 81.1%. Coclusion: Diagnostic benefit of HE4 can be considered especially in patients with increased risk of endometrial cancer and in patients with serious internal co-morbidities. HE4 could help in combination with clinical and ultrasound finding in the differentiation of prognostically various groups of patients and in decision-making in relation to the individualization of the treatment plan. However, the optimal cut-off for HE4 has not been solved yet, and to do so, it will require more research with larger studies and their comparative analysis..

• Klíčová slova
• benigní léze endometria, lidský epididymální protein 4 (HE4),
• MeSH
• adenokarcinom diagnóza   krev   patologie   MeSH
• antigen CA-125 krev   MeSH
• biopsie MeSH
• diferenciální diagnóza MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• logistické modely MeSH
• membránové proteiny krev   MeSH
• nádorové biomarkery * krev   MeSH
• nádory endometria * diagnóza   krev   patologie   MeSH
• nemoci dělohy diagnóza   krev   patologie   MeSH
• plocha pod křivkou MeSH
• prediktivní hodnota testů MeSH
• prospektivní studie MeSH
• proteiny * analýza   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• senzitivita a specificita MeSH
• staging nádorů MeSH
• studie případů a kontrol MeSH
• věkové rozložení MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• práce podpořená grantem MeSH
• srovnávací studie MeSH

AIM: The first aim of the project was to evaluate the benefits of the determination of human epididymis protein 4 (HE4) and the risk of ovarian malignancy algorithm (ROMA) index for primary detection of ovarian cancer in a population of Czech women. The second aim was to study the advantages HE4, cancer antigen 125 (CA125) and ROMA index for distinguishing between benign and malignant tumors. Aware of the age distribution of ovarian cancer, we focused on postmenopausal patients. PATIENTS AND METHODS: Our group of patients consisted of 256 females, 21 with ovarian cancer and 235 with benign ovarian tumors. All diagnoses were histologically verified. We determined the serum levels of HE4 and CA125 and calculated the ROMA2 index for postmenopausal women. Serum levels of the analytes were measured using an Architect 1000i instrument. Serum samples were collected prior to surgery or any other form of treatment and the results of the two groups of patients were compared (malignant vs. benign). RESULTS: There was a significant difference in the serum levels for all parameters studied between the groups of patients with malignant and those with benign diagnoses (Wilcoxon test, p<0.0001). When all parameters were evaluated at 95% specificity, the HE4 cut-off was 112 pmol/l at a sensitivity of 71.42%, a positive predictive value (PPV) of 55.56%, a negative predictive value (NPV) of 97.14% and an area under the curve (AUC) of 0.9152. The CA125 cut-off was 81 IU/l at a sensitivity of 80.95%, a PPV of 58.62%, a NPV of 98.23% and an AUC of 0.9731. ROMA2 index had a cut-off 37.70% at a sensitivity of 85.71%, a PPV of 62.06%, a NPV of 98.65% and an AUC of 0.9803. The highest diagnostic efficiency was achieved by the ROMA2 index. CONCLUSION: Determination of HE4 along with CA125 and ROMA2 index calculation is a suitable method for the improvement of the primary detection of ovarian cancer. This approach also improves the differential diagnostic possibilities for distinguishing between malignant and benign tumors.

• MeSH
• algoritmy MeSH
• antigen CA-125 krev   MeSH
• lidé středního věku MeSH
• lidé MeSH
• membránové proteiny krev   MeSH
• nádory vaječníků krev   MeSH
• nemoci ovaria krev   MeSH
• postmenopauza krev   MeSH
• proteiny metabolismus   MeSH
• věkové faktory MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH