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OBJECTIVE To investigate the value of human epididymis gene product 4 (HE4) in differential diagnosis of gynecological pelvic tumors.METHODS The level of serum HE4 in 132 women was determined. These women were divided into three groups, i.e.,46 women with good health being classified as the normal control(NC) group, and based on clinicopathological results, the other 86 with pelvic masses being classified into groups of benign (n = 56) and malignant lesions (n = 30), respectively.RESULTS The range of serum HE4 in the NC group was (23.5~46.0) pmol/L, with an average value of (34.1 ± 5.6) pmol/L;the range of serum HE4 in the benign lesion group was (30.1~58.9)pmol/L, with an average value of (39.1 ± 7.2) pmol/L; the range of serum HE4 in the group of malignancy was (31.2-1430.0) pmol/L, and the average value was (248.7 ± 364.5) pmol/L. The level of HE4 in the malignant lesion group was significantly higher than that in the other 2 groups, with a statistical difference, P < 0.001.The diagnostic index reached maximum (0.847) when the serum HE4 was at 51.6 pmol/L, and the sensitivity and specificity of HE4 were 86.7% and 98.0%, respectively. The area under the receiver- operator characteristic curve (ROC) was 0.935 (95% CI 0.832~1.037,P = 0.000). The consistency checking Kappa value of HE4 in the diagnosis of pelvic malignant tumors was 0.867, P = 0.000.CONCLUSION The determination of serum HE4 is a good indicator in differential diagnosis of benign and malignant ovarian tumors.