Human Epididymal Secretory Protein 4 of Early Diagnosis Value for Endometrial Cancer: A Systematic Review and Meta Analysis

Objective The diagnostic value of Human Epididymal Secretory Protein 4 (HE4) for Endometrial Cancer (EC) was assessed using Evidence-based medicine (EBM) and Systematic Review (SR) methodologies. Methods Relevant literature was obtained from databases such as The Cochrane Library, PubMed, Web of Science, EMBASE, CBM, CNKI, and Wan Fang Data up to April 1st, 2024. The Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool was utilized to evaluate the quality of the selected studies. Meta-analysis was conducted using Revman 5.3, STATA 16.1, and Meta-disc software. Results The analysis of 22 selected studies, comprising 3776 cases in the case group and 5260 cases in the control group with a total sample size of 9036 cases, revealed that HE4 exhibited a pooled sensitivity of 0.59 [95%CI (0.53, 0.64)], specificity of 0.93 [95%CI (0.88, 0.96)], positive likelihood ratio (PLR) of 6.87 [95%CI (4.57, 10.33)], negative likelihood ratio (NLR) of 0.46 [95%CI (0.39, 0.54)], diagnostic odds ratio (DOR) of 14.36 [95%CI (9.37, 21.17)], and area under the pooled receiver operating characteristic curve (AUC) of 0.78 [95%CI (0.75, 0.82)]. Conclusions HE4 demonstrates high specificity and moderate sensitivity in diagnosing EC, offering valuable assistance to clinicians either alone or in conjunction with other tumor markers.