{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T23:10:31Z","timestamp":1790809831038,"version":"4.1.0"},"reference-count":25,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To analyze the utility of carbohydrate antigen (CA)125 and human epididymis protein 4 (HE4) to detect malignancy in women with ovarian endometriosis, when ovarian cancer is suspected and ultrasonography results are inconclusive.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Women who underwent surgery between 2015 and 2019 for ovarian endometriosis or for adnexal masses, with a final diagnosis of ovarian carcinoma (clear cell and endometrioid) were included in this retrospective study. The women were divided into three groups: ovarian endometriosis (OE), ovarian carcinoma without endometriosis (OC), and ovarian carcinoma with endometriosis (OC\u2009+\u2009E). Adnexal masses were assessed preoperatively by transvaginal ultrasonography according to the International Ovarian Tumor Analysis (IOTA) simple rules, and CA125 and HE4 blood levels were obtained.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 208 women, 45 had malignancy, 16 in the OC\u2009+\u2009E group and 29 in the OC group. According to transvaginal ultrasonography, 13 were classified as undetermined risk of malignancy: OC group: 3, OE group: 3, and OC\u2009+\u2009E group: 7. When we compared the tumor biomarkers, significant differences in HE4 but not in CA125 levels were found between the groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>When ovarian malignancy is suspected in patients with ovarian endometriosis, HE4 is a more useful tumor biomarker to diagnose OC when ultrasonography results are inconclusive.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03000605211047701","type":"journal-article","created":{"date-parts":[[2021,9,30]],"date-time":"2021-09-30T13:30:06Z","timestamp":1633008606000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["HE4 might be a more useful tumor biomarker to detect malignancy in patients with ovarian endometrioma when malignancy is suspected"],"prefix":"10.1177","volume":"49","author":[{"given":"Mariona","family":"Rius","sequence":"first","affiliation":[{"name":"Endometriosis Unit, ICGON, Hospital Cl\u00ednic de Barcelona, Universitat de Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pere","family":"Fust\u00e9","sequence":"additional","affiliation":[{"name":"Gynecologic Oncology Unit, ICGON, Hospital Cl\u00ednic de Barcelona, Universitat de Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Ros","sequence":"additional","affiliation":[{"name":"Endometriosis Unit, ICGON, Hospital Cl\u00ednic de Barcelona, Universitat de Barcelona, Barcelona, Spain"},{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1ngeles","family":"Mart\u00ednez-Zamora","sequence":"additional","affiliation":[{"name":"Endometriosis Unit, ICGON, Hospital Cl\u00ednic de Barcelona, Universitat de Barcelona, Barcelona, Spain"},{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristian","family":"deGuirior","sequence":"additional","affiliation":[{"name":"Endometriosis Unit, ICGON, Hospital Cl\u00ednic de Barcelona, Universitat de Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meritxell","family":"Gracia","sequence":"additional","affiliation":[{"name":"Endometriosis Unit, ICGON, Hospital Cl\u00ednic de Barcelona, Universitat de Barcelona, Barcelona, Spain"},{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduard","family":"Mension","sequence":"additional","affiliation":[{"name":"Endometriosis Unit, ICGON, Hospital Cl\u00ednic de Barcelona, Universitat de Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0172-1761","authenticated-orcid":false,"given":"Francisco","family":"Carmona","sequence":"additional","affiliation":[{"name":"Endometriosis Unit, ICGON, Hospital Cl\u00ednic de Barcelona, Universitat de Barcelona, Barcelona, Spain"},{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), Barcelona, 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