Abstract: Objective：To explore the clinical value of HE4 detection in the screening of endometrial carcinoma (EC) in atypical endometrial hyperplasia (AEH) patients diagnosed with curettage pathology. Methods：Between January 2011 and December 2014, the blood specimens were collected from the patients subjected to total hysterectomy with a preoperative biopsy diagnosis of AEH in Tianjin Central Hospital of Gynecology Obstetrics. Serum levels of HE4, CA125 and CA199 were detected by the electro-chemiluminescent immunoassay. According to the postoperative pathology, patients were divided into EC group and AEH group, and the differences of the tumor markers in the two groups were analyzed. Evaluate the diagnosis accuracy of the tumor markers by the area under the curve of receiver operating characteristic (ROC-AUC). Results：31 cases were diagnosed with postoperative EC in all the 118 preoperative atypical endometrial hyperplasia patients. Their serum level of HE4, CA125 and CA199 were 73.4 pmol/L, 31.4 kU/L and 23.3 kU/L. 87 were still AEH after the operation, the serum level of above tumor marker were 44.3 pmol/L, 17.0 kU/L and 19.0 kU/L. The median levels of HE4, CA125 in EC group were significantly higher than those in AEH group, the difference was statistically significant (P＜0.05), while the CA199 level in the two groups was not statistically different (P＞0.05). The ROC-AUC of HE4 and CA125 were 0.785 and 0.706 respectively. The AUC and sensitivity of joint detection were 0.867 and 76.6%. Conclusions：Serum HE4 and CA125 levels in EC group were significantly higher than those in AEH group. Combined detection of HE4 and CA125 is helpful to discriminate EC in patients with a preoperative diagnosis of AEH.

Key words: Endometrial hyperplasia, Endometrial neoplasms, Epididymal secretory proteins, CA-125 antigen, Tumor markers, biological