Abstract
AIMS: Endometrial cancer (EC) is the most common gynecologic malignancy. Identifying prognostic biomarkers can improve outcome prediction and risk stratification. PATIENTS AND METHODS: This study evaluated the prognostic value of serum human epididymis protein 4 (HE4) levels and matrix metalloproteinase (MMP)9/MMP13 gene polymorphisms in EC. A total of 232 surgical EC patients (Jan 2021-Oct 2022) were analyzed. Progression-free survival (PFS) and overall survival (OS) were assessed. RESULTS: Significant differences in disease stage, tumor grade, and MMP9 R279Q and MMP13 rs2252070 phenotypes were found between patients with and without disease progression. Similarly, serum levels of carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), and HE4 also differed significantly between these groups. Significant differences were found between surviving patients and deceased patients in terms of stage (p < 0.001), grade (p < 0.001), HE4 level (p < 0.001), and CEA level (p = 0.001). The area under the receiver operating characteristic curve (AUC) for the three-year PFS prediction model was 0.935 (95% confidence interval [CI]: 0.891-0.978), and that for the OS model was 0.914 (95% CI: 0.845-0.983). CONCLUSIONS: HE4 is a valuable biomarker associated with three-year survival in EC. The phenotypes of MMP9 R279Q and MMP13 rs2252070 may also be associated with three-year PFS.