Ovarian cancer is the second most common gynecologic malignancy in developed countries and the third most common gynecologic malignancy in developing countries (cervical cancer is the most common) .Estimation of cancer antigen 125 (CA125) levels and transvaginal sonography are the best and most frequently recommended methods for diagnosing ovarian cancer [2,3,4]. HE4 and CA72-4 determination is the best approach to confirm the benign nature of ovarian endometrioma in women with high CA125 levels. 
when measured together with other tumoral markers (such as CA19.9 or CEA)CA125 was assessed by numerous investigators regarding its utility as a marker of stage, disease status, prognosis or even in the screening of ovarian cancer. 
HE4 is the most useful marker for the differ-ential diagnosis between EOC and ovarian endometriosis. the use of serumHE4, CA125 and CA72-4 may be a valuable approachfor distinguishing patients with ovarian endometriomaor other benign adnexal masses from those with ovarianmalignancy. This approach could reduce medical costsrelated to more expensive diagnostic procedures and itmay have a reassuring effect on the patient. 
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 Committee on Gynecologic Practice, Society of Gynecologic Oncology. Committee Opinion No. 716. Committee Opinion No. 716: the role of the obstetrician-gynecologist in the early detection of epithelial ovarian cancer in women at average risk. Obstet Gynecol 2017;130:e146-e149.
Anastasi, E., Granato, T., Falzarano, R. et al. The use of HE4, CA125 and CA72-4 biomarkers for differential diagnosis between ovarian endometrioma and epithelial ovarian cancer. J Ovarian Res 6, 44 (2013).
DANIELION,GEORGIANARADU,DANNICOLAEPĂDURARU, OCTAVIAN ANDRONIC, ALEXANDRA BOLOCAN. CA125 and CA242 markers' role in colorectal cancer diagnosis and management–a 30 year review. Romanian Biotechnological Letters 25(5):1977-1983. DOI:10.25083/rbl/25.5/1977.1983
Moore RG, Miller MC, Steinhoff MM, Skates SJ, Lu KH, Lambert-Messerlian G,Bast RC Jr: Serum HE4 levels are less frequently elevated than CA125 inwomen with benign gynecologic disorders. Am J Obstet Gynecol 2012,206(4):351.
Emanuela Anastasi, Teresa Granato, Renato Falzarano, Paola Storelli, Adele Ticino, Luigi Frati, Pierluigi Benedetti Panici, Maria Grazia Porpora. The use of HE4, CA125 and CA72-4 biomarkers for differential diagnosis between ovarian endometrioma and epithelial ovarian cancer. Journal of Ovarian Research 6(44). DOI:10.1186/1757-2215-6-44.