{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T04:02:15Z","timestamp":1793937735124,"version":"4.8.0"},"reference-count":43,"publisher":"Walter de Gruyter GmbH","issue":"12","license":[{"start":{"date-parts":[[2021,8,13]],"date-time":"2021-08-13T00:00:00Z","timestamp":1628812800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100012538","name":"Swedish Cancer Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012538","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005009","name":"The Assar Gabrielsson Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005009","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003744","name":"The Hjalmar Svensson Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003744","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The Gothenburg Medical Society"},{"DOI":"10.13039\/100016545","name":"Roche Diagnostics","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016545","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002794","name":"Cancerfonden","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002794","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_cclm-2021-0510_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the impact of different biologic, histopathologic and lifestyle factors on serum levels of human epididymis protein 4 (HE4) and Cancer antigen 125 (CA125) in the diagnostic work up of women with an ovarian cyst or pelvic tumor.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2021-0510_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The statistical evaluation was performed on a population of 445 women diagnosed with a benign ovarian disease, included in a large Swedish multicenter trial (\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/ClinicalTrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      NCT03193671). Multivariable logistic regression analyses were performed to distinguish between the true negatives and false positives through adjusting for biologic, histopathologic and lifestyle factors on serum samples of CA125 and HE4 separately. The likelihood ratio test was used to determine statistical significance and Benjamini-Hochberg correction to adjust for multiple testing.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2021-0510_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 31% of the women had false positive CA125 but only 9% had false positive results of HE4. Smoking (OR 6.62 95% CI 2.93\u201315.12) and impaired renal function, measured by eGFR (OR 0.18 95% CI 0.08\u20130.39), were independently predictive of falsely elevated serum levels of HE4. Endometriosis was the only variable predictive of falsely elevated serum levels of CA125 (OR 7.96 95% CI 4.53\u201314.39). Age correlated with increased serum levels of HE4.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2021-0510_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Smoking, renal failure, age and endometriosis are factors that independently should be considered when assessing serum levels of HE4 and CA125 in women with an ovarian cyst or pelvic mass to avoid false indications of malignant disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/cclm-2021-0510","type":"journal-article","created":{"date-parts":[[2021,8,13]],"date-time":"2021-08-13T13:58:32Z","timestamp":1628863112000},"page":"1954-1962","source":"Crossref","is-referenced-by-count":41,"title":["Consideration should be given to smoking, endometriosis, renal function (eGFR) and age when interpreting CA125 and HE4 in ovarian tumor diagnostics"],"prefix":"10.1515","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1371-4649","authenticated-orcid":false,"given":"Maria","family":"Lycke","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology , Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg and Region V\u00e4stra G\u00f6taland, Sahlgrenska University Hospital , Gothenburg , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Ulfenborg","sequence":"additional","affiliation":[{"name":"School of Bioscience, University of Sk\u00f6vde , Sk\u00f6vde , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Malchau Lauesgaard","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology , Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg and Region V\u00e4stra G\u00f6taland, Sahlgrenska University Hospital , Gothenburg , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bj\u00f6rg","family":"Kristjansdottir","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology , Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg and Region V\u00e4stra G\u00f6taland, Sahlgrenska University Hospital , Gothenburg , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Sundfeldt","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology , Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg and Region V\u00e4stra G\u00f6taland, Sahlgrenska University Hospital , Gothenburg , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2021,8,13]]},"reference":[{"key":"2023033112143569274_j_cclm-2021-0510_ref_001","doi-asserted-by":"crossref","unstructured":"Soletormos, G, Duffy, MJ, Othman Abu Hassan, S, Verheijen, RH, Tholander, B, Bast, RCJr., et al.. 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