HE4 blood test: meaning, normal range, and interpretation
The HE4 blood test measures a tumor marker used to detect ovarian cancer. Normal HE4 levels are below 70 pmol/L in premenopausal and 140 pmol/L in postmenopausal women. High HE4 levels may indicate malignancy or kidney disease, while low levels are normal. HE4 test results explained help assess cancer risk and monitor treatment.
Contents
Result interpretation HE4
What your result means based on common reference ranges
HE4 levels within normal range indicate low probability of ovarian cancer and stable tumor marker status.
Mildly elevated HE4 levels may reflect benign ovarian cysts or kidney dysfunction affecting protein clearance.
Significantly high HE4 levels suggest ovarian cancer progression or severe renal impairment requiring urgent evaluation.
Low HE4 levels are normal and may indicate effective cancer treatment or absence of tumor activity.
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What is HE4?
HE4 (Human Epididymis Protein 4) is a tumor marker measured in a blood test to evaluate ovarian cancer risk. It is produced by epithelial cells and increases in malignancies such as ovarian and endometrial cancer. Compared to CA125, HE4 is more specific and less affected by benign conditions like endometriosis. Clinically, HE4 levels are used in diagnosis, monitoring therapy response, and detecting recurrence. It is often combined with CA125 in the ROMA score for better risk assessment. Kidney function also influences HE4 levels, making interpretation dependent on creatinine and overall renal status.
Reference ranges
Causes of abnormal values
Causes of low HE4
- • Effective cancer treatment — removal of tumor cells reduces HE4 production
- • Remission — absence of active malignancy keeps levels low
- • Normal physiology — healthy individuals maintain low baseline HE4 levels
- • Early-stage disease absence — no significant tumor burden present
Causes of high HE4
- • Epithelial ovarian cancer — tumor cells overproduce HE4 protein into bloodstream
- • Endometrial cancer — malignant uterine tissue increases HE4 secretion
- • Lung cancer — adenocarcinoma cells may produce HE4
- • Chronic kidney disease — reduced filtration causes accumulation of HE4
- • Ovarian cysts — benign masses slightly elevate HE4 production
- • Smoking — lung tissue irritation increases baseline HE4 levels
HE4 in combination with other markers
Possible symptoms
- •Persistent abdominal bloating
- •Pelvic or lower abdominal pain
- •Early satiety or difficulty eating
- •Frequent or urgent urination
- •Unexplained weight loss
- •Chronic fatigue
When to see a doctor
Consult a doctor if HE4 levels exceed 70–140 pmol/L depending on menopausal status or continue rising. Seek immediate evaluation if elevated levels are combined with persistent pelvic symptoms or abnormal imaging findings.
What to do if abnormal
- Consult a gynecologic oncologist for interpretation
- Repeat HE4 blood test to monitor trends
- Perform ultrasound or CT scan for pelvic assessment
- Check creatinine to evaluate kidney function
- Track changes over time rather than single values
The information on this page is intended for general understanding of test results and does not replace medical consultation. Accurate interpretation requires considering other blood markers and individual factors.
Content is based on medical literature and used within the PulseBook analytical system.
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