Value of HE4,CA125,D-Dimer in the Diagnosis of Ovarian Cancer
SUN Ping
SHEN Yong
JIA Miaomiao
Abstract：Objective To explore the value of serum carbohydrate antigen 125(CA125),human epididymis protein 4(HE4),and plasma D-dimer in the diagnosis of ovarian cancer.Methods A retrospective analysis was conducted on 134 patients with ovarian tumors,including 102 cases of ovarian cancer and 32 cases of benign ovarian tumors,all confirmed by pathology.Serum levels of CA125 and HE4,along with plasma D-dimer levels,were measured.Multivariable logistic regression was used to control for confounding factors such as age and thrombosis.The diagnostic efficacy of individual and combined biomarkers was assessed using receiver operating characteristic(ROC)curves,and optimal cut-off values were determined.Age distribution and the relationship between D-dimer levels and age were analyzed,and the status of thrombotic complications in the ovarian cancer group was supplemented.Results There was no significant difference in age distribution between ovarian cancer group and benign group(P＞0.05).D-dimer levels showed a weak positive correlation with age(r=0.212,P=0.023).In the ovarian cancer group,the D-dimer positivity rate was significantly higher in patients with thrombosis compared to those without(P＜0.01).The positivity rates of serum CA125,HE4,and D-dimer in the ovarian cancer group were higher than those in the benign group(P＜0.01).ROC curve analysis demonstrated that the areas under the curve(AUC)for CA125,HE4,and D-dimer alone were 0.843,0.884,and 0.816,respectively.The combined detection of the three biomarkers yielded an AUC of 0.907(95％CI:0.856-0.958),with a sensitivity of 84.5％and a specificity of 89.7％.Among the 84 ovarian cancer patients with definitive FIGO staging,the positivity rates for CA125+HE4 were 64.5％in stages Ⅰ+Ⅱ and 88.7％in stagesⅢ+Ⅳ,while D-dimer positivity rates were 77.4％and 96.2％,respectively and the differences were statistically significant(P＜0.05).Conclusion The combined detection of serum CA125,HE4,and plasma D-dimer significantly enhances the diagnostic performance for ovarian cancer,offering both high sensitivity and high specificity.Furthermore,D-dimer levels are closely associated with tumor stage and hypercoagulable states,providing multidimensional evidence for the early diagnosis and clinical assessment of ovarian cancer.
Keywords：ovarian cancercarbohydrate antigen 125human epididymis protein 4D-dimer
Publication Date：2026-06-28
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：4( 2154-2157 )