Key Insights

• Understand how this test detects signals tied to ovarian cancer—helping reveal whether tumor‑related proteins are present at higher‑than‑expected levels.
• Identify a biomarker (HE4) that can help explain concerning findings like an adnexal mass on ultrasound, persistent bloating, or rising tumor markers.
• Learn how age, menopausal status, kidney function, smoking, and tumor subtype can influence your HE4 result and its meaning.
• Use insights to guide next steps with your clinician, such as combining HE4 with CA‑125, imaging, or the ROMA score to refine cancer risk assessment and treatment planning.
• Track how your levels change over time to monitor response after surgery or chemotherapy and to watch for possible recurrence.
• When appropriate, integrate this test’s findings with related panels—like CA‑125, inflammatory markers, and imaging—to build a more complete picture of ovarian health.

What Is a HE4 Test?

The HE4 test measures human epididymis protein 4 (gene: WFDC2) in your blood. HE4 is a protein commonly overproduced by epithelial ovarian cancers, especially serous and endometrioid subtypes. The test is typically performed on a serum sample using validated immunoassays (for example, chemiluminescent methods) designed to detect very small amounts with high specificity. Results are reported as a concentration (often in pmol/L) and interpreted against reference intervals that vary by laboratory method and by menopausal status.

This matters because HE4 behaves as a tumor biomarker: higher levels can reflect tumor activity, tumor burden, or recurrence risk. In practice, clinicians often pair HE4 with CA‑125 and imaging to stratify the likelihood that an ovarian mass is malignant and to monitor treatment response. While no single biomarker can “diagnose cancer,” adding objective HE4 data can uncover risk that isn’t obvious from symptoms alone and can help time-sensitive decisions—like referral to a gynecologic oncologist—happen sooner.

Why Is It Important to Test Your HE4?

Ovarian cancer can be quiet early on, but at the cellular level many tumors shed proteins that seep into the bloodstream. HE4 is one of those signals. Testing can reveal a pattern of overexpression linked to epithelial ovarian cancer, offering a biochemical readout that complements what clinicians see on ultrasound or CT. HE4 is also less affected than CA‑125 by benign conditions such as endometriosis, which can improve specificity when you’re trying to sort out an indeterminate adnexal mass. It is particularly relevant when imaging finds a complex ovarian cyst, when symptoms raise concern (like persistent abdominal fullness), and throughout treatment to gauge response.

Zooming out, HE4 supports prevention and outcomes by turning guesses into trend lines. Regular, targeted testing in the right clinical context helps detect early changes, track how surgery or chemotherapy is working, and flag potential recurrence sooner. The aim is not to “pass or fail” a single number, but to see where your biology stands and how it adapts over time—so your care team can match the intensity of care to the level of risk.

What Insights Will I Get From a HE4 Test?

Your report shows a numeric HE4 level compared with a laboratory’s reference range, which is method‑specific and often adjusted for menopausal status. “Normal” describes the range seen in a general, mostly healthy population. “Optimal” may be defined by your care team in relation to your history, imaging, and other biomarkers. Context matters: a result just above the cutoff can have very different implications in a person with normal imaging versus someone with a new complex mass.

When HE4 falls within the appropriate reference range for your lab and life stage, it generally suggests a lower probability of active epithelial ovarian cancer in the current context. In people undergoing treatment, falling HE4 over time can signal effective tumor debulking or response to therapy. Day to day variation happens, and levels can shift with age, kidney function, smoking, and assay differences.

Higher HE4 levels may indicate increased risk of epithelial ovarian cancer, especially when paired with concerning imaging or elevated CA‑125. Rising values after treatment may point to residual disease or recurrence. That said, elevated HE4 does not equal a diagnosis. Kidney impairment can raise HE4 because the protein is cleared renally, and some benign gynecologic or inflammatory conditions can nudge levels upward. Conversely, certain tumor subtypes (for example, mucinous ovarian tumors) may not produce much HE4, so a low value cannot rule out cancer if imaging is suspicious.

The real strength of this test is pattern recognition over time. Interpreted alongside CA‑125, the ROMA score (which combines HE4, CA‑125, and menopausal status), and imaging, HE4 helps your clinician separate signal from noise. Think of it like tracking your heart‑rate trends during training: one datapoint is interesting, but the trend line is what guides smarter decisions for early detection, treatment monitoring, and long‑term vigilance.