Value of serum marker HE4 in pulmonary carcinoma diagnosis

An effective blood test is valuable to aid clinicians in making case management decisions. The present study was to analyze the value of four serum tumor markers for the diagnosis of pulmonary carcinoma. The case group consisted of 80 pulmonary carcinoma patients, which were compared to a control group of 30 patients with benign pulmonary disease and a control group of 30 healthy individuals. Serum levels of carcinoma embryonic antigen (CEA), cytokeratin protein fragment 21-1 (CYFRA21-1), neuron-specific enolase (NSE), and human epididymis protein 4 (HE4) were detected using electrochemiluminescence. Serum CEA, NSE, CYFRA21-1, and HE4 levels were significantly higher in pulmonary carcinoma patients than those in both control groups (P < 0.05). Serum CEA and HE4 levels were significantly higher in adenocarcinoma patients, while serum CYFRA21-1 levels were significantly higher in squamous cell carcinoma patients and serum NSE levels were significantly higher in small cell lung cancer (SCLC) patients (P < 0.05). Analysis of area-under-the-receiver operating characteristic (ROC) curves (AUC) revealed that serum CYFRA21-1, CEA, and HE4 levels were valuable for squamous cell carcinoma, serum CEA and HE4 levels were valuable for adenocarcinoma, and serum NSE level was valuable for SCLC (P < 0.05). Serum CEA and HE4 levels of pulmonary carcinoma patients with metastasis were higher than those with TNM stage I-II or III-IV disease without metastasis. In brief, detection of serum HE4 levels may be useful in auxiliary diagnosis and evaluation of the progression of pulmonary carcinoma.