evaluation of tumor markers in endometrial cancer differentiation and abnormal uterine bleeding: a systematic review and meta-analysis

Endometrial cancer (ec) is a malignancy of the uterine, causing 42,000 deaths. there are two types: type i, which mainly affects postmenopausal women and is marked by endometrioid histology, and type ii, which lacks endometrioid histology and is not associated with hormonal risk factors. the most common symptom is abnormal uterine bleeding, seen in over 90% of patients. molecular diagnostics like saline infusion sonohysterography and transvaginal sonography (tvs) are crucial for diagnosing ec. currently, only a few biomarkers, such as he4, ca125, and ca153, are available for ec detection, but relying on a single indicator can lead to inaccurate diagnoses. early identification of noninvasive serologic diagnostic markers is crucial for improving diagnostic efficiency in ec. combining multiple indicators like fibrinogen (fib) and d-dimer (d2), which are linked to tumor metastasis and adverse outcomes, can enhance this process. blood tests for surgical guidance and risk stratification in different genetic subgroups could help detect deep myometrial invasion and lymph node metastasis. analyzing circulating tumor dna (ctdna), circulating tumor cells, and inflammatory markers aids in early endometrial cancer (ec) diagnosis. circulating tumor cells correlate with tumor size, stage, survival, and non-endometrioid histology. protein combinations like swi/snf and cadherin levels, especially n-cadherin, are potential prognostic indicators. tet enzymes play a role in dna methylation. monitoring cytokines (il-4, il-6, il-8) helps track ec progression, with low il-4 and high il-8 indicating higher risk. combining menopausal status with cytokines and ca125 enhances risk assessment. early detection using multiple indicators can improve diagnostic efficiency and patient outcomes.