Background: Serum biomarkers such as Carcinoma Antigen 125 (CA125) and Human Epididymis Protein 4 (HE4) are widely used in the diagnosis and prognosis of gynecological malignancies. Serum biomarkers such as CA125 and HE4 represent essential tools in improving early detection, risk stratification, and therapeutic decision-making for gynecological malignancies. However, their role in identifying uterine sarcomas remains debated. This systematic review and case series aims to examine the diagnostic and prognostic significance of CA125 and HE4 in uterine sarcomas.Methods: A systematic review was performed on studies investigating serum CA125 and HE4 levels in uterine sarcomas. A case series of all uterine sarcomas treated at the Campus Bio-Medico Gynecology Unit of Rome from 2010 to 2020 was analyzed.Results: The analysis of the 11 selected studies allowed us to investigate the role of CA125 in uterine sarcomas. No studies analyzing the role of HE4 in monitoring the disease were found. A total of 16 patients with confirmed uterine leiomyosarcoma were included in our case series.Conclusions: Neither CA125 nor HE4 can currently be considered definitive biomarkers for the diagnosis of uterine leiomyosarcomas. However, they may serve as useful adjuncts in the differential diagnosis between leiomyomas and leiomyosarcomas, particularly in reproductive-age patients.
背景：血清生物标志物如癌抗原125（CA125）和人附睾蛋白4（HE4）被广泛应用于妇科恶性肿瘤的诊断与预后评估。这些标志物是提升妇科恶性肿瘤早期检测、风险分层及治疗决策水平的重要工具，但其在子宫肉瘤鉴别中的作用仍存争议。本系统综述与病例系列研究旨在探讨CA125和HE4在子宫肉瘤中的诊断及预后价值。 方法：对研究子宫肉瘤患者血清CA125和HE4水平的文献进行系统综述，并分析了2010年至2020年罗马生物医学园区妇科中心收治的所有子宫肉瘤病例系列。 结果：通过对11项入选研究的分析，我们探讨了CA125在子宫肉瘤中的作用。未发现专门研究HE4在疾病监测中作用的相关文献。本病例系列共纳入16例经确诊的子宫平滑肌肉瘤患者。 结论：目前CA125和HE4均不能被视为诊断子宫平滑肌肉瘤的确诊性生物标志物。然而，在子宫肌瘤与平滑肌肉瘤的鉴别诊断中，尤其是在育龄期患者中，它们可作为有价值的辅助诊断指标。
肿瘤(癌症)患者之家