Diagnostic performance of human epididymis protein 4 in predicting occult endometrial carcinoma among women with endometrial intraepithelial neoplasia

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.