Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology · 2026
Lymphocyte markers with CA125 and HE4 for diagnosing early endometrial cancer in postmenopausal women: case-control study.
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Xie Cheng Hong, Cao Hua Rong
Аннотация
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.
RESULTS: The EC group had higher rates of diabetes, hypertension and dyslipidaemia (all p < .05), lower LYM and LMR (all p < .01) and higher CA125 and HE4 (all p < .001). Among single markers, HE4 had the highest area under the curve (AUC, 0.725) but low sensitivity (45.8%). The combination of CA125 and HE4 achieved an AUC of 0.759; adding LYM and LMR increased this to0.839. Incorporating metabolic factors further increased the AUC to 0.865 (Akaike information criterion, AIC = 144), which was superior to other models (p < 0.01).
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.
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.
RESULTS: The EC group had higher rates of diabetes, hypertension and dyslipidaemia (all p < .05), lower LYM and LMR (all p < .01) and higher CA125 and HE4 (all p < .001). Among single markers, HE4 had the highest area under the curve (AUC, 0.725) but low sensitivity (45.8%). The combination of CA125 and HE4 achieved an AUC of 0.759; adding LYM and LMR increased this to0.839. Incorporating metabolic factors further increased the AUC to 0.865 (Akaike information criterion, AIC = 144), which was superior to other models (p < 0.01).
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.