Human Epididymis Protein 4 (HE4) Test
About Human Epididymis Protein 4 (HE4) Test
| Field | Value |
|---|---|
| Also Known As | HE4, WFDC2, Human Epididymis Secretory Protein E4, WAP Four-Disulfide Core Domain Protein 2 |
| Sample Type | Serum (venous blood) |
| Fasting Required | No fasting required; avoid biotin (vitamin B7) supplements for at least 72 hours before collection |
| Report Time | Within 5 days |
| Recommended For | Adult women aged 18 years and above, particularly those with a pelvic mass or undergoing ovarian cancer monitoring |
| Price | Starting at ₹2,900 |
What is a Human Epididymis Protein 4 (HE4) Test?
The HE4 test measures the level of Human Epididymis Protein 4 in the blood. This protein is produced by most epithelial ovarian cancer cells and can be elevated in women with certain ovarian conditions. Doctors typically order this test to monitor women already being treated for ovarian cancer or to assess pelvic masses before surgery. Also known as WFDC2 or Human Epididymis Secretory Protein E4, the test uses a serum sample drawn from a vein in the arm.
What Does a Human Epididymis Protein 4 (HE4) Test Measure?
The HE4 test procedure measures a single protein marker in the blood, but that result is often used as part of a broader assessment. The key components are described below.
| Component | What it Tells You |
|---|---|
| HE4 Protein Level | The amount of Human Epididymis Protein 4 circulating in the blood; elevated levels are associated with epithelial ovarian cancer |
| ROMA Score (if calculated) | A risk score combining HE4 and CA-125 with menopausal status to estimate the likelihood of malignancy in a pelvic mass |
Why is a Human Epididymis Protein 4 (HE4) Test Done?
A doctor may order this test for several reasons, from initial investigation of symptoms to ongoing disease monitoring.
Common Symptoms That May Require This Test
The following symptoms may prompt a doctor to request an HE4 test:
- Persistent bloating or abdominal swelling
- Pelvic or abdominal pain
- Feeling full quickly when eating
- Increased urinary frequency
- Unexplained fatigue
- Unintentional weight loss
- A known or suspected pelvic mass
Conditions This Test Can Help Detect
This test can assist in identifying or monitoring several conditions. These include:
- Epithelial ovarian carcinoma, including serous, endometrioid, and clear cell types
- Malignant versus benign pelvic masses, as a pre-operative assessment tool
- Lung cancer, where HE4 may serve as a supplementary marker (not its primary use)
Human Epididymis Protein 4 (HE4) Test for Chronic Disease Monitoring
The HE4 test has a well-established role in post-treatment monitoring of ovarian cancer patients who had elevated HE4 levels before therapy. When ordered alongside CA-125, it provides a more complete picture of whether treatment has been effective and whether the cancer has returned. A baseline reading is usually taken before treatment begins, with repeat tests carried out periodically thereafter.
How to Prepare and What to Expect
Preparation for this test is straightforward. The key step is managing your biotin intake before undertaking the test.
Do You Need to Fast?
No fasting is required before the HE4 test. You may eat and drink normally on the day of your appointment. However, avoid biotin (vitamin B7) supplements for at least 72 hours before your sample is collected, as biotin can interfere with the test result.
Practical Tips Before Your Test
Keep the following points in mind before attending your appointment:
- Stop taking biotin-containing supplements, multivitamins, or hair, skin, and nail supplements at least 72 hours before collection
- Bring a detailed clinical history, including your symptoms, previous test results, and any relevant medical records, as this is required for the test
- Inform the collection team about your menopausal status and any current medications
- Carry copies of any previous HE4 test results so the doctor can compare values over time
Step-by-Step Procedure
The HE4 test procedure involves a simple blood draw. Here is what to expect:
- A trained phlebotomist (blood collection specialist) will clean a small area on your inner arm.
- A needle is gently inserted into a vein to draw approximately 3 ml of blood into a gel-barrier tube.
- The needle is removed, and light pressure is applied to the site; the process takes under two minutes.
- The collected sample is centrifuged (spun in a machine) to separate the serum from blood cells.
- The serum is transferred into a vial and refrigerated for transport to the laboratory.
- At the lab, the HE4 protein concentration is measured by the EIA (enzyme immunoassay) method, and your report is prepared within 5 days.
Factors That Can Affect Accuracy
Several factors can influence your result. Be aware of the following:
- Biotin supplementation, which can cause false readings if not stopped before the test
- Certain antibodies (human antimouse antibodies) may cause falsely high or low values
- Smoking, which is associated with higher HE4 serum levels
- Age, as HE4 concentrations tend to rise naturally in women over 40
- Kidney disease, which can raise HE4 independently of cancer
Understanding Your Human Epididymis Protein 4 (HE4) Test Results
Your results should always be reviewed with a qualified doctor, who will consider them alongside your symptoms, menopausal status, imaging findings, and other tests. The table below shows general reference ranges.
| Parameter | Healthy Range | Unit |
|---|---|---|
| HE4 (All healthy women) | 85 or below | pmol/L |
| HE4 (Premenopausal women) | 73 or below | pmol/L |
| HE4 (Postmenopausal women) | 93 to 150 | pmol/L |
These ranges are general guidelines. Your doctor will interpret your results based on your age, health history, and other factors. Always consult a qualified healthcare professional for personalised medical advice.
Results During Special Conditions
Certain conditions can affect how results are interpreted:
- Kidney disease: Women and men with renal failure can have significantly elevated HE4 levels unrelated to ovarian cancer. A doctor will factor this in before drawing any conclusion.
- Smoking: Active smokers tend to have higher baseline HE4 values. Your smoking status will be considered alongside your result.
- Age: Women above 40 years may show naturally higher HE4 concentrations, which is why age-specific reference ranges are used.
- Pregnancy: HE4 concentrations during pregnancy differ from standard reference ranges and must be interpreted with care.
How to Maintain Healthy Levels
While HE4 is a clinical marker rather than a lifestyle one, the following general habits support overall health:
- Attend regular health check-ups, particularly if you have a family history of ovarian cancer or other risk factors.
- Avoid smoking, which is known to raise HE4 levels and carries broader health risks.
- Monitor kidney function regularly if you have diabetes, high blood pressure, or other conditions that affect the kidneys.
Lupin Diagnostics Human Epididymis Protein 4 (HE4) Test Price and Home Collection
The HE4 test cost at Lupin Diagnostics starts at ₹2,900, and home sample collection is available for your convenience. The table below shows approximate prices across major cities.
| City | Approximate Price (₹) |
|---|---|
| BHOPAL | 2100 |
| CHENNAI | 2100 |
| HYDERABAD | 2900 |
| KOLKATA | 2100 |
| NAVI MUMBAI | 2900 |
| PUNE | 2100 |
Prices are indicative and may vary by location. Please confirm the current price at the time of booking.
How to Book
Follow these steps for HE4 test online booking with Lupin Diagnostics:
- Select the Human Epididymis Protein 4 (HE4) Test on the Lupin Diagnostics website.
- Choose your city and preferred time slot.
- Opt for home sample collection by a certified phlebotomist, or visit your nearest Lupin Diagnostics centre.
- Receive your report via email or WhatsApp within 5 days of sample collection.
Home Collection
HE4 test home collection is available across cities, making it easy to have your sample collected from the comfort of your home by a trained phlebotomist. All samples are processed in NABL-accredited laboratories that meet strict quality standards. Your digital report is delivered directly to you, so no centre visit is needed to access your results.
Frequently Asked Questions
The HE4 test is primarily used to monitor women who have been treated for epithelial ovarian cancer, helping to detect whether the cancer has returned or progressed. It is also used alongside CA-125 to assess whether a pelvic mass is likely to be malignant or benign before surgery. It is not intended as a general screening test for ovarian cancer.
The ROMA (Risk of Ovarian Malignancy Algorithm) score combines the HE4 level, CA-125 level, and a woman's menopausal status into a single risk calculation. It helps doctors estimate whether a pelvic mass is likely to be cancerous before an operation. A higher ROMA score suggests a greater likelihood of malignancy.
HE4 is elevated in many ovarian cancer patients whose CA-125 levels are within the normal range. Ordering both tests together improves the overall accuracy of the assessment. Together, they give a more complete picture than either marker can provide alone.
Yes. Elevated HE4 levels have been recorded in people with chronic kidney disease, even without any cancer present. If you have a kidney condition, your doctor will interpret your result with this in mind and may order additional tests to clarify the finding.
Yes, smoking is associated with higher HE4 serum levels. If you smoke, inform your doctor before the test so that your result can be interpreted in the right context.
No. Certain ovarian cancer types, such as mucinous or germ cell tumours, rarely produce HE4. For these cancer types, the HE4 test is not recommended for monitoring purposes. Your doctor will advise whether this test is appropriate based on your specific diagnosis.
The frequency depends on your doctor's recommendations and your treatment plan. Typically, the test is done before treatment to establish a baseline and then repeated at regular intervals during and after treatment to track how well therapy is working and to watch for any sign of recurrence.
Human Epididymis Protein 4 (HE4) Test
