Serum CD93 as a Potential Diagnostic Biomarker for Endometrial Cancer: A Case-Control Study

Objectives: CD93, an angiogenesis-related transmembrane glycoprotein, is transcriptomically downregulated in uterine corpus endometrial carcinoma, yet circulating protein levels have not been clinically evaluated. This study aimed to evaluate serum CD93 as a diagnostic biomarker for EC and to examine its association with clinicopathological parameters. Methods: In this single-center case-control study, serum CD93 concentrations were measured by enzyme-linked immunosorbent assay in 46 patients with histologically confirmed primary EC and 35 controls with histologically verified benign gynecological pathology. Logistic regression and receiver operating characteristic (ROC) curve analyses were performed. Results: Serum CD93 was significantly lower in EC patients than controls (median 4.55 [IQR 3.51-6.97] vs. 10.24 [7.18-12.14] ng/mL; p < 0.001). In multivariable analysis adjusted for age and body mass index, lower CD93 remained independently associated with EC (OR = 0.521; 95% CI 0.061-0.720; p < 0.001). ROC analysis yielded an area under the curve of 0.845 (95% CI 0.759-0.921), with 82.6% sensitivity and 74.3% specificity at a cut-off of 7.338 ng/mL. CD93 levels showed no significant association with histological subtype, grade, lymphovascular space invasion, nodal metastasis, or recurrence. Conclusions: Serum CD93 is significantly reduced in EC and demonstrates independent diagnostic performance, supporting its prospective validation as a non-invasive biomarker in larger multicenter cohorts.