Abstract: ob＜x＞jective To investigate the ex＜x＞pression of human epididymal protein 4 (HE4) in patients with different pathological ovarian lesions and its relationship with prognosis and survival of epithelial ovarian cancer (EOC). Methods 26 cases of ovarian benign tumors, 20 cases of EOCs, 25 cases of chocolate cysts, and 25 cases of other tumor-like lesions diagnosed in our hospital from January 2015to July 20 17 were set as group A, B, C, and D, respectively. The serum HE4 levels in each group were detected and its differential diagnostic value for different ovarian lesions was determined. C orrelation between HE4 ex＜x＞pression and clinicopathological features and prognosis of EOC patients was determined. Results HE4 level was the highest in group B , followed by group A, group C and group D, with statistic difference (P<0.05). Tumor grade, stage, me＜x＞tastasis and HE4 level were independent risk factors affecting the prognosis of EOC patients (P<0.05). OS and PFS in patients with low ex＜x＞pression of HE4 were higher than those with high ex＜x＞pression of HE4 (P<0.05). Conclusion HE4 is expressed at different levels in different pathological ovarian lesions, and its level is correlated with tumor grade, tumor stage, tumor me＜x＞tastasis and prognosis of EOC patients, which can provide reference basis for early diagnosis and treatment and prognosis assessment of EOC patients.