Open AccessFalsely elevated human epididymis protein 4 results and Risk of Ovarian Malignancy Algorithm in polymorbid women after solid organ transplantation: A pilot and case‐control study
Author(s) -
Franeková Janka,
Cindr Josef,
Lavríková Petra,
Komrsková Jitka,
Sečník Peter,
Lánská Věra,
Jabor Antonín
Publication year - 2018
Publication title -
journal of clinical laboratory analysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.536
H-Index - 50
eISSN - 1098-2825
pISSN - 0887-8013
DOI - 10.1002/jcla.22432
Subject(s) - creatinine , medicine , transplantation , urology , gastroenterology , malignancy , epididymis , endocrinology , gynecology , andrology , sperm
Background Cancer prevention is essential after transplantation (Tx). The use of HE 4 and Risk of Ovarian Malignancy Algorithm ( ROMA ) is recommended as a tool for selective ovarian cancer screening; however, creatinine is a known confounder. This study assessed the reliability of HE 4, CA 125, and ROMA after Tx. Methods We matched a total of 202 women without gynecological malignancies and 236 men by age and serum creatinine. Each pair consisted of a patient after Tx (kidney, liver, heart, and pancreas) and a diseased but non‐Tx consecutive patient. Serum HE 4, CA 125 (Roche Cobas 6000), and creatinine (enzymatic, Abbott Architect) were measured in all patients. Results Creatinine correlated with HE 4 (women: r = .864, P < .0001; men: r = .848, P < .0001). Age correlated slightly with HE 4 in women ( r = .250, P < .005) and men ( r = .240, P < .0005). HE 4 in women after Tx (median of 84.8 pmol/L) was significantly higher than non‐Tx women (53.7 pmol/L, P < .0001) in the reference range of serum creatinine. Neither HE 4 nor CA 125 correlated with tacrolimus concentration, but anemia, hyperparathyroidism, kidney, liver, and lung diseases were possible confounders for HE 4 after transplantation ( P < .05). Conclusion Human epididymis protein 4 (HE4) was significantly increased in women after solid organ transplantation compared to levels without transplants matched by age and serum creatinine. HE 4 results may be misleading in these patients.