{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T11:27:23Z","timestamp":1774438043699,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,11,12]],"date-time":"2016-11-12T00:00:00Z","timestamp":1478908800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea","award":["HI13C1364"],"award-info":[{"award-number":["HI13C1364"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Human epididymis protein 4 (HE4) is a novel biomarker for epithelial ovarian cancer. This study was designed to evaluate the role of HE4 in chemo\u2010response against anti\u2010cancer drugs and prognosis of epithelial ovarian cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>HE4\u2010depleted cells and HE4\u2010overexpressing cells were generated. The effect of HE4 gene silencing and overexpression was examined using a cell viability assay after exposure to chemotherapeutic agents and the signaling pathway. We studied the expression of HE4 in ovarian cancer tissue and the prognostic significance. Cytoplasmic staining was graded for intensity and percentage of positive cells. The grades were multiplied to determine an H\u2010score.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Knockdown of HE4 in OVCAR\u20103 cells resulted in reduction in cell growth and increased sensitivity to paclitaxel and cisplatin compared to control cells. This effect originated from the decreased activation of cell\u2010growth\u2010related signaling, such as AKT and Erk mediated by epidermal growth factor (EGF), while overexpression of HE4 resulted in enhanced cell growth and suppressed the anti\u2010tumorigenic activity of paclitaxel. Activation of AKT and Erk pathways was enhanced in HE4\u2010overexpressing cells compared to control cells. Based on the results of multivariate analysis, the risk of death was significantly higher in patients with an H\u2010score\u00a0&gt;\u00a04.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>HE4 induces chemoresistance against anti\u2010cancer drugs and activates the AKT and Erk pathways to enhance tumor survival. HE4 expression in ovarian cancer tissue is associated with a worse prognosis for epithelial ovarian cancer patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jog.13181","type":"journal-article","created":{"date-parts":[[2016,11,15]],"date-time":"2016-11-15T04:17:43Z","timestamp":1479183463000},"page":"220-227","source":"Crossref","is-referenced-by-count":32,"title":["Role of human epididymis protein 4 in chemoresistance and prognosis of epithelial ovarian cancer"],"prefix":"10.1111","volume":"43","author":[{"given":"Seungho","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Gachon University, Gil Medical Center  Incheon Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seowon","family":"Choi","sequence":"additional","affiliation":[{"name":"Laboratory of Cancer Cell Biology Lee Gil Ya Cancer and Diabetes Institute, Gachon University  Incheon Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yookyung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Cheil General Hospital and Women's Healthcare Center  Seoul Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donghae","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Pathology Gachon University, Gil Medical Center  Incheon Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suntaek","family":"Hong","sequence":"additional","affiliation":[{"name":"Laboratory of Cancer Cell Biology Lee Gil Ya Cancer and Diabetes Institute, Gachon University  Incheon Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nohhyun","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Seoul National University, College of Medicine  Seoul Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,11,12]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-60327-492-0_20"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.4143\/crt.2016.089"},{"key":"e_1_2_7_4_1","unstructured":"Surveillance Epidemiology and End Results (SEER) Program.SEER 9 Incidence & U.S. Mortality Research Data (1973\u20132011). 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