Paper Title
Evaluation of HE4, CA125 as a Diagnostic Tools in the Differential Diagnosis of Ovarian Cancer in Albanian Women

Abstract
Ovarian cancer (OC) is potentially curable if diagnosed, but in developing countries like our over 70% of women with OC are diagnosed at an advanced stage. The study aim: To compare the utility of the two parameters, HE4, CA 125, for risk stratification and diagnostic purpose in patients with benign and malignant ovarian tumor in different stage. We have determined HE4 and serum levels in 179 healthy women, 33 patients with benign gynecological diseases and 53 patients with active gynecological cancer. Statistical processing of data has been aiming to discover the connection between the measured parameters, sensitivity and their accuracy in detecting the OC. In early stage of OC the areas under the curve (AUC) were 0.911 for HE4 and 0.722 for CA 125. The dimensions of this surface show that in this group HE4 was more sensitive and specific than CA 125. In the case of the individuals in the advanced stage of OC, AUC were 0.950 for HE4, and 0.948 for CA 125. The dimensions of this surface show that in this group both markers have almost the same level of sensitivity and specificity. From the study results, we come to the conclusion that neither HE4 nor CA125 are not perfect indicators in the differential diagnosis of OC. HE4 is a marker with a better sensitivity and specificity than CA 125 in identifying the initial stages of the disease while in the advanced stages both markers have the same level of sensitivity and specificity. Keywords - Ovarian Cancer (OC), HE4, CA125, Differential Diagnosis