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Stains

HE4

Authors: Kara Hamilton, M.S. and Nat Pernick, M.D., PathologyOutlines.com, Inc.

Revised: 22 September 2012, last major update July 2009

Terminology

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● Antibody against Human Epididymis protein 4, a protease inhibitor

● Also called WAP5 and WFDC2 (WAP four-disulfide core domain 2)

Uses

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● Ovarian serum tumor marker (Cancer Epidemiol Biomarkers Prev 2009;18:1365, Br J Cancer 2009;100:1315)

● May be useful for screening in combination with CA-125 (Gynecol Oncol 2009;112:40)

● Greater specificity than CA-125 for diagnosing early ovarian cancer (eMedicine)

Positive stains - normal

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● Breast (female)

● Colonic mucosa

● Epididymis (Biol Reprod 1991;45:350) and vas deferens

● Female genital tract (endocervix, endometrium, fallopian tube, ovary)

● Renal tubules

● Respiratory epithelium

● Salivary glands

Positive stains - disease

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● Ovarian carcinoma (Cancer Res 2003;63:3695), particularly serous and endometrioid (Cancer Res 2005;65:2162)

● Breast, endometrial, GI, pancreatic carcinoma (some, Mod Pathol 2006;19:847)

● Lung adenocarcinoma (some)

● Mesothelioma (some)

● Cystic fibrosis of lung (Respir Res 2006;7:61)

Negative stains

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● Most non-ovarian carcinomas

Micro images

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Respiratory tract and                        Cystic fibrosis of lung

salivary glands

Ovarian carcinoma-various subtypes                         

Various tumors

End of Stains chapter > HE4

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