Lymphocyte markers with CA125 and HE4 for diagnosing early endometrial cancer in postmenopausal women: case-control study

BACKGROUND: Endometrial cancer (EC) is common in postmenopausal women, with early diagnosis critical for prognosis. Traditional tumour markers (CA125, HE4) are limited alone, and the diagnostic value of peripheral blood lymphocyte-related indicators is unclear. This study explored the value of combining these lymphocyte indicators with CA125, HE4 and metabolic factors for early EC diagnosis in postmenopausal women. METHODS: This is a single-centre case-control study that included 72 postmenopausal women with early EC (FIGO I-II, EC group) and 72 with benign uterine lesions (BL group). Baseline data, immunological markers (lymphocyte count, LYM; lymphocyte-to-monocyte ratio, LMR), CA125 and HE4 were measured. Receiver operating characteristic curves were used to analyse diagnostic performance, and multivariate logistic regression compared model fit. CONCLUSION: Combining lymphocyte indicators (LYM, LMR), CA125, HE4 and metabolic factors significantly improved early EC diagnostic efficacy in postmenopausal women, offering a reliable non-invasive strategy.