Abstract
BACKGROUND: Early detection of micrometastatic disease in endometrial carcinoma (EC) remains a major clinical challenge. This study evaluated Migration Inducing Gene 7 (MIG7) and Trefoil Factor Family 3 (TFF3) as minimally invasive biomarkers for EC progression. METHODS: MIG7 and TFF3 gene expression and circulating TFF3 protein levels were analyzed in 75 subjects: healthy controls (n = 25), non-metastatic EC (n = 25), and metastatic EC (n = 25). Diagnostic performance was assessed using ROC analysis and logistic regression. RESULTS: A significant stepwise increase was observed from controls to metastatic EC in MIG7 expression (0.69 vs. 1.97), TFF3 expression (0.38 vs. 2.03), and TFF3 protein levels (0.41 vs. 6.09; P < 0.001). Diagnostic accuracy was high, with AUC values of 0.945, 0.998, and 0.999, respectively. TFF3 gene expression showed the highest balanced performance (96% sensitivity, 100% specificity). MIG7 and TFF3 expression were strongly correlated (r = 0.818, P < 0.001). All markers independently predicted metastatic disease (P < 0.05). CONCLUSION: MIG7 and TFF3 are robust minimally invasive biomarkers for EC detection and metastatic risk stratification. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12885-026-15783-z.