---
title: "Combining lymphocyte markers with CA125 and HE4 to improve early endometrial cancer diagnosis in p"
id: "pubmed-42726666"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42726666"
content_type: "clinical_feed_article"
specialty: "Oncology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42726666/"
doi: "10.1080/01443615.2026.2719764"
published_at: "2026-09-11T12:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Combining lymphocyte markers with CA125 and HE4 to improve early endometrial cancer diagnosis in p
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42726666
- **Specialty:** [Oncology](https://medichelpline.com/clinical-feed/oncology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42726666/)
- **DOI:** [10.1080/01443615.2026.2719764](https://doi.org/10.1080%2F01443615.2026.2719764)
- **Published At:** 2026-09-11T12:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This single-centre case-control study compared 72 postmenopausal women with early endometrial cancer (FIGO I–II) to 72 postmenopausal women with benign uterine lesions. - The study evaluated peripheral blood **lymphocyte** indicators (lymphocyte count, LYM; lymphocyte-to-monocyte ratio, LMR), tumour markers **CA125** and **HE4**, and metabolic comorbidities (diabetes, hypertension, dyslipidaemia). - The endometrial cancer (EC) group had higher prevalence of diabetes, hypertension and dyslipidaemia (all reported p < .05). - Patients with EC showed lower **LYM** and **LMR** (both p < .01) and higher **CA125** and **HE4** levels (both p < .001) versus the benign lesion (BL) group. - Among single markers, **HE4** produced the highest area under the curve (AUC = 0.725) but with limited sensitivity (45.8%). - The combination of **CA125 + HE4** yielded an AUC of 0.759. Adding **LYM** and **LMR** increased the AUC to 0.839. - Further inclusion of metabolic factors (history of diabetes, hypertension, dyslipidaemia) raised the AUC to 0.865; this model had an Akaike information criterion (AIC) of 144 and was statistically superior to other models (p < 0.01). - The authors conclude that combining lymphocyte indicators with **CA125**, **HE4**, and metabolic factors substantially improved non-invasive early EC diagnostic performance in postmenopausal women. - The source did not report additional methodological details (for example assay cut-offs, exact model coefficients, or external validation) beyond what is summarized in the abstract.
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Epub 2026 Sep 11. # Lymphocyte markers with CA125 and HE4 for diagnosing early endometrial cancer in postmenopausal women: case-control study [Cheng Hong Xie](https://pubmed.ncbi.nlm.nih.gov/?term=Xie+CH&cauthor_id=42726666)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42726666/#full-view-affiliation-1 "Department of Gynaecology and Obstetrics, Yichang Central People's Hospital, The First College of Clinical Medical Science, China Three Gorges University, Yichang City, Hubei Province, China."), [Hua Rong Cao](https://pubmed.ncbi.nlm.nih.gov/?term=Cao+HR&cauthor_id=42726666)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42726666/#full-view-affiliation-1 "Department of Gynaecology and Obstetrics, Yichang Central People's Hospital, The First College of Clinical Medical Science, China Three Gorges University, Yichang City, Hubei Province, China.") Affiliations Expand ### Affiliation * 1 Department of Gynaecology and Obstetrics, Yichang Central People's Hospital, The First College of Clinical Medical Science, China Three Gorges University, Yichang City, Hubei Province, China. * PMID: **42726666** * DOI: [ 10.1080/01443615.2026.2719764 ](https://doi.org/10.1080/01443615.2026.2719764) Item in Clipboard # Lymphocyte markers with CA125 and HE4 for diagnosing early endometrial cancer in postmenopausal women: case-control study Cheng Hong Xie et al. J Obstet Gynaecol. 2026 Dec. Show details Display options Display options Format Abstract PubMed PMID J Obstet Gynaecol Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22J+Obstet+Gynaecol%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22J+Obstet+Gynaecol%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42726666/) . 2026 Dec;46(1):2719764. doi: 10.1080/01443615.2026.2719764. Epub 2026 Sep 11. ### Authors [Cheng Hong Xie](https://pubmed.ncbi.nlm.nih.gov/?term=Xie+CH&cauthor_id=42726666)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42726666/#short-view-affiliation-1 "Department of Gynaecology and Obstetrics, Yichang Central People's Hospital, The First College of Clinical Medical Science, China Three Gorges University, Yichang City, Hubei Province, China."), [Hua Rong Cao](https://pubmed.ncbi.nlm.nih.gov/?term=Cao+HR&cauthor_id=42726666)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42726666/#short-view-affiliation-1 "Department of Gynaecology and Obstetrics, Yichang Central People's Hospital, The First College of Clinical Medical Science, China Three Gorges University, Yichang City, Hubei Province, China.") ### Affiliation * 1 Department of Gynaecology and Obstetrics, Yichang Central People's Hospital, The First College of Clinical Medical Science, China Three Gorges University, Yichang City, Hubei Province, China. * PMID: **42726666** * DOI: [ 10.1080/01443615.2026.2719764 ](https://doi.org/10.1080/01443615.2026.2719764) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **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. **Keywords:** CA125; Endometrial cancer; HE4; logistic models; lymphocyte count. ## Plain language summary Endometrial cancer (EC) is a common cancer in women after menopause. Finding it early is very important for treatment and recovery. Currently, relying on just one blood test to detect early EC is not very effective. Our study explored a new combined assessment method. We compared 72 women after menopause who had early EC with 72 women who had non-cancerous uterine conditions. In addition to testing common cancer blood markers, we also analysed other blood cell indicators linked to the immune system and recorded whether the women had health conditions like diabetes or high blood pressure. The study found that combining these immune cell indicators with the traditional cancer markers was better at identifying women with early EC. When the women’s own health conditions related to body metabolism (such as a history of diabetes or high blood pressure) were also included, this combined assessment method became the most accurate. This means that for women after menopause, using a few simple blood tests together with personal health information can help doctors detect signs of EC earlier and more accurately, allowing for earlier treatment. 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