WFDC2 and ovarian cancer: Nevertheless, Castella et al., who also evaluated changes in CA-125 and HE4 levels among 72 patients with ovarian cancer, reported that an increase in biomarkers corresponded with disease recurrence, confirmed by diagnostic imaging, in most patients, although in some women, there was an upward trend in the CA-125 and HE4 levels not associated with recurrence (34).