Abstract:           Background and purpose: Human epididymis protein 4 (HE4) has been suggested to be a novel biomarker of epithelial ovarian cancer (EOC). The present study aimed to evaluate and compare HE4 with the commonly used marker, carbohydrate antigen 125 (CA125) and imaging examinations in detecting the recurrence of postoperative EOC. Methods: In this study, 92 patients with the recurrence of postoperative EOC were analyzed retrospectively. The treatments method included the secondary operation (48 patients) and chemotherapy (44 patients). The sensitivity of CA125, HE4 and CT/MRI examinations in detecting the recurrence of postoperative EOC were analyzed and correlated with surgical pathology and clinical follow-up results. Results: The sensitivity of CA125 and HE4 were 58.7% and 61.9% with no significant difference (P>0.05). The diagnostic sensitivity of CA125 combined with HE4 (80.4%) was statistically higher than that of 2 tumor marks being applied independently (P>0.05). The diagnostic sensitivity of CT/MRI examinations (88.0%) was statistically higher than that of CA125 and HE4 (P<0.05), and no significant difference was observed between CT/MRI and combined CA125 and HE4 (P>0.05). The highest diagnostic sensitivity (97.8%) was attained by combining of CA125, HE4 and CT/MRI examinations, which was statistically high- er than that of CA125 combined with HE4 (P<0.01), and CT/MRI examinations (P<0.05). Conclusion: Serum HE4 is an effective tumor marker in detecting the recurrence of postoperative EOC as well as serum CA125. HE4 and CA125 may improve the diagnostic sensitivity statistically. The highest diagnostic sensitivity was attained by combining of CA125, HE4 and CT/MRI examinations, which is the suitable strategy in screening the patient of postoperative EOC.

Key words: Ovarian neoplasm, Neoplasm recurrence, Carbohydrate antigen 125, Human epididymis protein 4, Imaging diagnosis