Eurasian Journal of Medicine and Oncology
Diagnostic performance of human epididymis protein 4 in predicting occult endometrial carcinoma among women with endometrial intraepithelial neoplasia
By Aysel Mammadova and Gulnara Jafarova.
Abstract
Introduction
Endometrial intraepithelial neoplasia (EIN) carries a substantial risk of concurrent occult endometrial carcinoma. Accurate preoperative risk assessment is important for appropriate surgical planning Objective: To assess the diagnostic accuracy of serum human epididymis protein 4 (HE4) in identifying occult endometrial carcinoma in women with EIN, compare its performance with cancer antigen 125 (CA-125) and the Risk of Ovarian Malignancy Algorithm (ROMA) index, and assess the value of integrating clinical, ultrasonographic, histopathological, and biomarker variables into a preoperative prediction model.
Methods
This retrospective study included 113 women with histologically confirmed EIN who underwent hysterectomy between 2019 and 2025. Clinical, ultrasonographic, histopathological, and biomarker data, including serum CA-125, HE4, and ROMA, were evaluated. Diagnostic performance was assessed using receiver operating characteristic analysis, and independent predictors were identified by multivariable logistic regression.