Serum human epididymis protein 4, endocan, sialyl-Tn, and neopterin in endometrial cancer: a prospective case–control study

OBJECTIVE: The aim of this study was to compare serum levels of endocan, human epididymis protein 4, sialyl-Tn antigen, and neopterin between women with endometrial cancer and asymptomatic healthy controls, and to explore their discriminatory performance in this case-control setting and clinicopathological associations. METHODS: Prospective case-control study of 133 women with endometrial cancer and 65 healthy controls. Serum biomarkers were measured before treatment by enzyme-linked immunosorbent assays. Discrimination was evaluated using the area under the receiver operating characteristic curve with optimal cut-offs. RESULTS: Endocan levels were significantly higher in endometrial cancer patients than in controls (p<0.001), with an area under the curve of 0.758. Serum human epididymis protein 4 was also elevated in patients (p<0.001), with an area under the curve of 0.702. Neopterin and sialyl-Tn did not differ significantly between groups. Endocan and human epididymis protein 4 were higher in women with lymphovascular space invasion (both p<0.05); however, these associations did not remain significant after correction for multiple comparisons. CONCLUSION: Serum endocan and human epididymis protein 4 were elevated in endometrial cancer patients compared to asymptomatic healthy controls. Neopterin and sialyl-Tn showed no discriminatory value in this setting. Our findings should be interpreted as exploratory and require validation in clinically relevant cohorts.