Objective To investigate the application value of combined detection of serum human epididymis protein 4 (HE4),cancer antigen 125 (CA125) and cancer antigen 19-9 (CA 19-9) in early endometrial carcinoma.Methods Two hundred and six patients with early endometrial carcinoma (endometrial carcinoma group) and 118 patients with uterine fibroids (uterine fibroids group) were selected.Serum level of HE4 was measured by enzyme linked immunosorbent assay (ELISA),and serum levels of CA 125 and CA 19-9 were measured by chemiluminescence immunoassay(CLIA).The positive rates of serum HE4,CA125 and CA19-9 in the 2 groups were compared.The changes between pre-and post-operative in the serum levels of serum HE4,CA125 and CA19-9 were compared in 147 endometrial carcinoma patients.Results The serum levels of HE4 and CA19-9 in endometrial carcinoma group were significantly higher than those in uterine fibroids group [76.57 (56.92-104.60) pmol/L vs.56.75 (48.33-68.91) pmol/L,13.26(6.07-25.90) kU/L vs.7.64(3.76-16.45) kU/L],there were statistical differences (P =0.000),there was no statistical difference in serum level of CA125 between the 2 groups (P=0.106).In endometrial carcinoma group,the positive rates of serum HE4 and HE4 + CA125 + CA19-9 were significantly higher than the positive rates of serum CA125,CA19-9,CA125+CA19-9,there were statistical differences (P ＜ 0.01).The positive rates of serum HE4,CA19-9,HE4 +CA125,HE4 +CA19-9 and HE4 +CA125 +CA19-9 in endometrial carcinoma group were significantly higher than those in uterine fibroids group,there were statistical differences (P ＜ 0.01).The serum levels of HE4,CA125 and CA19-9 in post-operative in 147 endometrial carcinoma patients were significantly lower than those in pre-operative,there were statistical differences (P ＜ 0.01).Conclusion The diagnostic value of serum HE4 in early endometrial carcinoma is better than CA125 and CA19-9,while combined detection of serum HE4,CA125 and CA19-9 can raise the positive rate and be helpful for therapeutic effect evaluation.