Year: 2026 | Month: April | Volume: 16 | Issue: 4 | Pages: 207-218
DOI: https://doi.org/10.52403/ijhsr.20260425
Diagnostic Accuracy of CA125 and HE4 in Differentiating Benign and Malignant Ovarian Masses in a Tertiary Care Setting in India: A Prospective Study
Eva Raman1, Shuchi Agrawal2, Preeti Agrawal3, Shalini Singh4, Sameer Gupta5, Avinash Agrawal6
1Resident, Department of Obstetrics & Gynaecology, King George’s Medical University, Lucknow, UP.
2Additional Professor, Department of Obstetrics and Gynecology, King George’s Medical University, Lucknow.
3Professor, Department of Pathology, King George’s Medical University, Lucknow, UP.
4Additional Professor, Department of Obstetrics & Gynaecology, King George’s Medical University, Lucknow.
5Professor, Department of Surgical Oncology, King George’s Medical University, Lucknow, UP.
6Professor, Department of Critical Care Medicine, King George’s Medical University, Lucknow, UP.
Corresponding Author: Dr. Shuchi Agrawal
ABSTRACT
Background: Ovarian cancer often follows indolent course resulting in delayed diagnosis and presentation at advanced stage and poor clinical outcomes. Ultrasonography, though widely used has limitations in differentiating benign and malignant lesions. Serum tumor markers such as Cancer Antigen-125 (CA125) and Human Epididymis Protein-4 (HE4) have been investigated for their role in diagnosis of ovarian neoplasms.
Aims: To assess the diagnostic accuracy of serum CA125 and HE4, alone and in combination, in differentiating benign and malignant ovarian neoplasms
Materials and Methods: 186 patients with ultrasound-diagnosed ovarian tumors were included, Detailed demographic and clinicopathological data were recorded after obtaining informed consent. Patients with chronic kidney disease, and pregnancy were excluded. Preoperative serum CA125 and HE4 levels were measured. All patients underwent surgical management, and the final histopathological diagnosis was considered the gold standard. Sensitivity, specificity, and diagnostic accuracy of CA125 and HE4 was assessed individually and in combination.
Results: CA125 demonstrated higher sensitivity (86.1%) compared with HE4 (76.4%), while HE4 showed greater specificity (87.7%) than CA125 (65.8%). The combined use of CA125 and HE4 yielded a sensitivity of 81.3% and specificity of 76.8%, indicating improved diagnostic performance compared with either marker alone.
Conclusion: The Integrated assessment of CA125 and HE4 may improve diagnostic evaluation of ovarian neoplasms and assist in distinguishing benign from malignant lesions, thereby facilitating early clinical decision-making.
Key words: CA125, HE4, epithelial ovarian neoplasm.