Objective To investigate the clinical value of transvaginal ultrasound combined with serum zinc finger E-box-binding homeobox 1(ZEB1)and lymphocyte activation gene 3(LAG-3)in the early diagnosis of endometrial cancer.Methods From July 2021 to August 2023,totally 97 suspected patients with endometrial cancer who visited the hospital were collected in the study.After endometrial biopsy,they were separated into malignant group(46 cases)and benign group(51 cases).The clinical and pathological characteristics of the patients were collected,vaginal ultrasound examination was performed on the patients,and serum ZEB1 mR-NA and LAG-3 levels were detected.Kappa test was applied to analyze the consistency between transvaginal ultrasound,ZEB1 mRNA,LAG-3,and their combined diagnosis and biopsy diagnosis.Receiver operating char-acteristic(ROC)curve was applied to compare the value of transvaginal ultrasound,ZEB1 mRNA,LAG-3 and their combination in the early diagnosis of endometrial cancer.Results The levels of ZEB1mRNA and LAG-3 in the malignant group were higher than those in the benign group(P＜0.05).Patients with International Federation of Gynecology and Obstetrics(FIGO)staging＞grade Ⅱ,deep muscle infiltration,distant metas-tasis,low-grade had higher ZEB1mRNA and LAG-3 levels than patients with FIGO staging≤grade Ⅱ,su-perficial muscle infiltration,no distant metastasis and medium to high differentiation(P＜0.05).The consis-tency combined between transvaginal ultrasound,ZEB1mRNA,LAG-3 diagnosis and biopsy diagnosis(Kappa=0.751)was higher than that of the three individual diagnoses(Kappa=0.647,0.605,0.666).The area un-der the curve(AUC)of combined transvaginal ultrasound,ZEB1mRNA,and LAG-3 in the diagnosis of early endometrial cancer was the largest,which was 0.925,with sensitivity of 84.78％,specificity of 90.20％,accu-racy of 87.63％,and Youden index of 0.750.Conclusion The expression of serum ZEB1 and LAG-3 is rela-tively high in patients with early endometrial cancer.The levels of serum ZEB1 and LAG-3 are related to the clinical characteristics of patients.The combination of transvaginal ultrasound,ZEB1,and LAG-3 has high clinical value in the early diagnosis of endometrial cancer.