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.

Keywords: CA125; HE4; gynecological cancer; serum biomarkers; uterine sarcoma.

背景：血清生物标志物如癌抗原125（CA125）和人附睾蛋白4（HE4）在妇科恶性肿瘤的诊断和预后中被广泛使用。这些生物标志物对于提高早期检测、风险分层以及治疗决策制定具有重要意义。然而，它们在识别子宫肉瘤中的作用仍存在争议。本系统综述和病例系列研究旨在探讨CA125和HE4在子宫肉瘤中的诊断和预后意义。方法：对调查血清中CA125和HE4水平的子宫肉瘤相关研究进行了系统回顾，并分析了罗马卡姆普斯生物医学妇科单元从2010年到2020年间治疗的所有子宫肉瘤病例系列。结果：所选的11项研究的分析使我们能够探讨CA125在子宫肉瘤中的作用。未发现评估HE4在监测疾病中作用的研究。共有16名确诊为子宫平滑肌肉瘤的患者纳入我们的病例系列研究。结论：目前，无论是CA125还是HE4都不能被视为诊断子宫平滑肌肉瘤的确诊生物标志物。然而，在鉴别诊断平滑肌瘤和子宫肉瘤时（特别是在生育年龄女性中），它们可能具有一定的辅助作用。 关键词：

CA125; HE4; 妇科癌症; 血清生物标志物; 子宫肉瘤.