HE4 — What It Means in Your Blood Test
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Tumour marker results are complex. This page explains what the test measures — your doctor or specialist interprets your result in full clinical context, alongside your history and other tests.
What HE4 cannot tell you
HE4 is not a stand-alone test for cancer. Reduced kidney clearance, age and some benign conditions raise it, and a normal result does not rule cancer out. A specialist reads it with CA-125 and imaging [SGO, 2020].
This is a protein some tissues release, cleared by the kidneys, that certain conditions raise.
HE4 is usually read together with CA-125 when a specialist is assessing an ovarian concern. Reduced kidney clearance and age can lift it, so it is weighed in context.
Also known as: Human epididymis protein 4, HE4 test
This isn't a case where higher or lower is better. Your body keeps it in a narrow band, and both directions can matter.
Last reviewed: 2026-08-16
What does HE4 do in your body?
A gynaecology specialist uses HE4 alongside CA-125 to help judge a pelvic mass and to track an ovarian problem already found. It is less affected by endometriosis than CA-125 [SGO, 2020].
What is HE4?
HE4 (human epididymis protein 4) is a small protein made by several tissues and removed by the kidneys. When kidney clearance falls, or certain conditions are present, more appears in the blood.
Why is HE4 tested?
You may have this test as a specialist assesses a pelvic mass, or follows a known ovarian condition. It is read with CA-125 and a scan.
What can raise HE4
Common, non-cancer causes
- Reduced kidney function, since the kidneys clear HE4 from the blood [NACB, 2010]
- Older age, especially after menopause, which nudges the level up [SGO, 2020]
- Some benign lung and other conditions [NACB, 2010]
Causes a doctor will also consider
- Ovarian cancer, which a specialist assesses using HE4 with CA-125 and imaging [SGO, 2020]
- Some other cancers, considered only in full clinical context [NACB, 2010]
One HE4 value means little alone. A specialist reads it with CA-125, an examination and a scan, and watches the trend across readings [SGO, 2020].
What is a normal HE4 range?
- India
- No India-specific national reference interval is published for this parameter; your lab's printed range is the most reliable comparison.
- Global
- Laboratories report HE4 against age- and menopause-related references, and reduced kidney clearance raises it; what a value means depends on the wider picture [SGO, 2020]
Ranges vary by lab, method and equipment — the range printed on your own report is the one that applies to your result.
Source: [SGO, 2020]
What does your HE4 value mean?
There is no widely-accepted set of value bands for this parameter. Compare your result with the reference range printed on your own report, and discuss it with your doctor.
What does a high HE4 result mean?
A raised HE4 often reflects reduced kidney clearance or age. A specialist weighs these with CA-125 and a scan before any next step.
What does a low HE4 result mean?
A low or within-range HE4 is reassuring when read with CA-125. A scan and examination still guide the assessment, as no single marker is enough.
What can affect your HE4 result?
- Kidney function
- Age and menopausal status
- The laboratory method — the same lab is used for monitoring
- Some benign lung conditions
Questions to ask your doctor
About this result
- My HE4 is [value] pmol/L — read with my CA-125 and scan, how concerned should we be?
- Could my kidney function or age explain my HE4?
What to do next
- Should HE4 and CA-125 be repeated together to show the trend?
- Do my markers and scan together point to any next step?
Frequently asked questions
- What is HE4?
- HE4 (human epididymis protein 4) is a small protein made by several tissues and removed by the kidneys. When kidney clearance falls, or certain conditions are present, more appears in the blood. You may have this test as a specialist assesses a pelvic mass, or follows a known ovarian condition. It is read with CA-125 and a scan.
- What is a normal HE4 test (ovarian marker) range?
- A typical adult range is around Laboratories report HE4 against age- and menopause-related references, and reduced kidney clearance raises it; what a value means depends on the wider picture [SGO, 2020]. No India-specific national reference interval is published for this parameter; your lab's printed range is the most reliable comparison. Ranges vary by lab, method and equipment — the range printed on your own report is the one that applies to your result.
- What does a high HE4 result mean?
- A raised HE4 often reflects reduced kidney clearance or age. A specialist weighs these with CA-125 and a scan before any next step.
- What does a low HE4 result mean?
- A low or within-range HE4 is reassuring when read with CA-125. A scan and examination still guide the assessment, as no single marker is enough.
- What can affect your HE4 result?
- Several everyday factors can influence it, including Kidney function, Age and menopausal status, The laboratory method — the same lab is used for monitoring, Some benign lung conditions.
Sources
- SGO (2020) — Society of Gynecologic Oncology Clinical Practice Statement: Next Steps in the Evaluation of a Pelvic Mass
- NACB (2010) — NACB Laboratory Medicine Practice Guidelines: Use of Tumor Markers in Testicular, Prostate, Colorectal, Breast, and Ovarian Cancers
- ACOG (2016) — ACOG Practice Bulletin: Evaluation and Management of Adnexal Masses
Part of the Tumour Markers
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