{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:50:43Z","timestamp":1785113443145,"version":"3.55.0"},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,3,24]],"date-time":"2018-03-24T00:00:00Z","timestamp":1521849600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Laboratory Analysis"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Cancer prevention is essential after transplantation (Tx). The use of <jats:styled-content style=\"fixed-case\">HE<\/jats:styled-content>4 and Risk of Ovarian Malignancy Algorithm (<jats:styled-content style=\"fixed-case\">ROMA<\/jats:styled-content>) is recommended as a tool for selective ovarian cancer screening; however, creatinine is a known confounder. This study assessed the reliability of <jats:styled-content style=\"fixed-case\">HE<\/jats:styled-content>4, <jats:styled-content style=\"fixed-case\">CA<\/jats:styled-content>125, and <jats:styled-content style=\"fixed-case\">ROMA<\/jats:styled-content> after Tx.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>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\u2010Tx consecutive patient. Serum <jats:styled-content style=\"fixed-case\">HE<\/jats:styled-content>4, <jats:styled-content style=\"fixed-case\">CA<\/jats:styled-content>125 (Roche Cobas 6000), and creatinine (enzymatic, Abbott Architect) were measured in all patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Creatinine correlated with <jats:styled-content style=\"fixed-case\">HE<\/jats:styled-content>4 (women: <jats:italic>r<\/jats:italic>\u00a0=\u00a0.864, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.0001; men: <jats:italic>r<\/jats:italic>\u00a0=\u00a0.848, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.0001). Age correlated slightly with <jats:styled-content style=\"fixed-case\">HE<\/jats:styled-content>4 in women (<jats:italic>r<\/jats:italic>\u00a0=\u00a0.250, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.005) and men (<jats:italic>r<\/jats:italic>\u00a0=\u00a0.240, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.0005). <jats:styled-content style=\"fixed-case\">HE<\/jats:styled-content>4 in women after Tx (median of 84.8\u00a0pmol\/L) was significantly higher than non\u2010Tx women (53.7\u00a0pmol\/L, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.0001) in the reference range of serum creatinine. Neither <jats:styled-content style=\"fixed-case\">HE<\/jats:styled-content>4 nor <jats:styled-content style=\"fixed-case\">CA<\/jats:styled-content>125 correlated with tacrolimus concentration, but anemia, hyperparathyroidism, kidney, liver, and lung diseases were possible confounders for <jats:styled-content style=\"fixed-case\">HE<\/jats:styled-content>4 after transplantation (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>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. <jats:styled-content style=\"fixed-case\">HE<\/jats:styled-content>4 results may be misleading in these patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcla.22432","type":"journal-article","created":{"date-parts":[[2018,3,25]],"date-time":"2018-03-25T06:39:36Z","timestamp":1521959976000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Falsely elevated human epididymis protein 4 results and Risk of Ovarian Malignancy Algorithm in polymorbid women after solid organ transplantation: A pilot and case\u2010control study"],"prefix":"10.1002","volume":"32","author":[{"given":"Janka","family":"Franekov\u00e1","sequence":"first","affiliation":[{"name":"Department of Laboratory Methods Institute for Clinical and Experimental Medicine  Prague Czech Republic"},{"name":"Third Faculty of Medicine Charles University  Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josef","family":"Cindr","sequence":"additional","affiliation":[{"name":"Gynecology Outpatient Department Institute for Clinical and Experimental Medicine  Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra","family":"Lavr\u00edkov\u00e1","sequence":"additional","affiliation":[{"name":"Department of Laboratory Methods Institute for Clinical and Experimental Medicine  Prague Czech Republic"},{"name":"Third Faculty of Medicine Charles University  Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jitka","family":"Komrskov\u00e1","sequence":"additional","affiliation":[{"name":"Department of Laboratory Methods Institute for Clinical and Experimental Medicine  Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"Peter","family":"Se\u010dn\u00edk","sequence":"additional","affiliation":[{"name":"Department of Laboratory Methods Institute for Clinical and Experimental Medicine  Prague Czech Republic"},{"name":"Third Faculty of Medicine Charles University  Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V\u011bra","family":"L\u00e1nsk\u00e1","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Institute for Clinical and Experimental Medicine  Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4144-3129","authenticated-orcid":false,"given":"Anton\u00edn","family":"Jabor","sequence":"additional","affiliation":[{"name":"Department of Laboratory Methods Institute for Clinical and Experimental Medicine  Prague Czech Republic"},{"name":"Third Faculty of Medicine Charles University  Prague Czech 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