Background: Endometrial carcinoma (EC) is a common gynecologic malignancy, with rising incidence. Unfortunately, it has poor prognosis with declining 5-years survival rate. Discovering target biomarkers for EC is essential to identify novel therapeutic options. Minichromosome maintenance 2 (MCM2) and Trans-glutaminase 2 (TGM2) are of these studied biological biomarkers.

Patients and methods: This prospective study was carried out on 60 patients diagnosed with EC. All patients were treated and followed up at Tanta University Hospitals. Immunohistochemistry was performed using MCM2 and TGM2 primary antibodies, as well as serum TGM2 levels were measured and compared with other clinicopathological parameters.

Results: MCM2 and TGM2 showed high expressions in 53.3% & 48.3% of cases respectively. Their expressions were associated with myometrial, cervical, lympho-vascular invasion, and higher tumor grade (P <0.001, P = 0.022, P = 0.011, P = 0.017 respectively) for MCM2 and (P = 0.032, P = 0.012, P = 0.001, P =0.035 respectively) for TGM2. High MCM2 expression was associated with advanced FIGO stage (P = 0.001). High serum TGM2 levels were associated with serous type EC compared to endometrioid type (P = 0.02) and with the presence of myometrial invasion (P <0.001). The 3-years disease free survival rate was 78.33%. Univariate analysis revealed that FIGO staging, myometrial, lymphovascular invasion, MCM2 and TGM2 expressions, together with TGM2 serum levels had statistically significant relation to DFS.

Conclusions: High MCM2 and TGM2 expressions as well as high serum TGM2 levels are significantly associated with unfavorable prognostic factors and poor survival outcome in EC patients.