Diagnostic value of serum human epididymis protein 4 in esophageal squamous cell carcinoma

Table 1 Comparison of serum marker levels

Group	n	HE4 (pmol/L)	CEA (ng/mL)	AFP (ng/mL)	CA19-9 (ng/mL)
Case group	80	5.746 ± 3.360	4.274 ± 2.530	3.358 ± 1.559	8.450 ± 5.157
Benign control group	56	3.294 ± 1.738	2.471 ± 1.702	2.561 ± 1.587	5.271 ± 4.636
P value		< 0.0001	0.0022	0.0042	0.0003

HE4: Human epididymis protein 4; CEA: Carcinoma embryonic antigen; AFP: Alpha fetal protein; CA19-9: Carbohydrate antigen 19-9.

Table 2 Comparison of serum marker levels for diagnosing esophageal squamous cell carcinoma

Variable	AUC	Standard error	Asymptotic significance	Asymptotic 95%CI
HE4	0.795	0.038	0.000	0.717-0.859
CEA	0.737	0.043	0.000	0.665-0.809
AFP	0.666	0.049	0.001	0.580-0.744
CA19-9	0.697	0.047	0.000	0.612-0.773

AUC: Area under the curve; HE4: Human epididymis protein 4; CEA: Carcinoma embryonic antigen; AFP: Alpha fetal protein; CA19-9: Carbohydrate antigen 19-9.

Table 3 Comparison of sensitivity and specificity of serum markers for esophageal squamous cell carcinoma (%)

Variable	HE4	CEA	AFP	CA19-9
Sensitivity	66.2	53.7	65.0	73.1
Specificity	85.7	82.1	66.0	60.7

HE4: Human epididymis protein 4; CEA: Carcinoma embryonic antigen; AFP: Alpha fetal protein; CA19-9: Carbohydrate antigen 19-9.

Table 4 Summary of sensitivity and specificity of each biomarker in combination with each other

Variable combination	AUC	Standard error	Asymptotic significance	Asymptotic 95%CI
HE4 + CEA	0.828	0.034	0.000	0.761-0.895
HE4 + AFP	0.819	0.036	0.000	0.748-0.890
HE4 + CA19-9	0.837	0.034	0.000	0.770-0.904
CEA + AFP	0.775	0.041	0.000	0.696-0.855
CEA + CA19-9	0.790	0.039	0.000	0.713-0.867
AFP + CA19-9	0.717	0.045	0.000	0.635-0.805

AUC: Area under the curve; HE4: Human epididymis protein 4; CEA: Carcinoma embryonic antigen; AFP: Alpha fetal protein; CA19-9: Carbohydrate antigen 19-9.

Table 5 Correlation of characteristics of esophageal squamous cell carcinoma patients with serum human epididymis protein 4 levels, n (%)

	Total	Serum HE4 levels		P value
		≤ 3.9 ng/mL	> 3.9 ng/mL
All cases	80	27	53
Gender				0.4395
Male	56 (70.0)	17 (63.0)	39 (73.6)
Female	24 (30.0)	10 (47.0)	14 (26.4)
Tumor location				0.6777
Upper	16 (23.8)	5 (18.5)	11 (20.8)
Middle	45 (56.4)	14 (51.9)	31 (58.4)
Lower	19 (23.8)	8 (29.6)	11 (20.8)
T grade				0.0002
T1-2	21 (26.3)	14 (51.9)	7 (13.2)
T3-4	59 (73.7)	13 (48.1)	46 (86.8)
N stage				0.0017
N0	26 (32.5)	15 (55.6)	11 (20.8)
N1-2	54 (67.5)	12 (44.4)	42 (79.2)

HE4: Human epididymis protein 4.