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Objective To explore the predictive value of serum human epididymis protein 4 (HE4) marker in the preoperative prediction of the risk of advanced disease in the endometrioid subtype of endometrial cancer, and its association with poor prognostic factors. In addition, a cut‐off value of HE4 was defined to classify patients according to these results. Methods Prospective and multicenter cohort analytical pilot study of patients operated for endometrial cancer at the Miguel Servet University Hospital of Zaragoza (Spain) and the Complejo Universitario of León (Spain) from January 2017 to May 2019. Preoperative serum levels of HE4 were analyzed by clinical and pathologic characteristics. Results In all, 126 patients were included. A statistically significant association was found between the preoperative HE4 value and node involvement (P = 0.008), late‐stage disease (P = 0.003), high histologic grade (P = 0.007), deep myometrial invasion (P = 0.001), lymphovascular space invasion (P = 0.001), and other pathologic factors. In addition, an HE4 cut‐off value (156.4 pmol/L) has been determined to predict, preoperatively, which patients will present with early stage disease. Conclusions The preoperative marker HE4 is a useful tool in the preoperative study of patients with endometrial cancer as it relates to late‐stage disease as well as other prognostic factors in the endometrioid subtype of endometrial cancer.

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Neisseria gonorrhoeae es el segundo agente etiológico de enfermedad inflamatoria pélvica y actualmente sigue infradiagnosticado debido a su presentación asintomática en la mitad de los casos. Cuando presenta síntomas puede debutar con un abdomen agudo y pruebas de imagen normales, suponiendo un importante reto diagnóstico.Se presentan cuatro casos de peritonitis aguda por gonococo. El síntoma principal fue dolor abdominal agudo, mientras que la exploración ginecológica y las pruebas complementarias resultaron normales. Mediante laparoscopia, el único hallazgo relevante fue la existencia de líquido ascítico purulento. El estudio anatomopatológico del apéndice resultó normal en todos los casos. El cultivo endocervical y de líquido ascítico mostró infección por N. gonorrhoeae y, en un caso, infección concomitante con Chlamydia trachomatis. El tratamiento definitivo fue la antibioterapia intravenosa.Ante el diagnóstico de una peritonitis sin causa aparente en una mujer joven sexualmente activa es relevante descartar enfermedades de transmisión sexual.Palabras clave. Pelviperitonitis gonocócica. Enfermedad inflamatoria pélvica. Dolor abdominal agudo. Diagnóstico diferencial.