Elevated expression of ECT2 as a diagnostic marker and prognostic indicator in endometrial cancer

•ECT2 is upregulated in p53abn EC, indicating a poorer prognosis, but lower in MMRd and NSMP, suggesting a moderate prognosis.•ECT2 expression increases from normal to EC, accurately distinguishing between benign and malignant endometria.•High ECT2 expression correlates with unfavorable prognosis, suggesting its potential as a prognostic indicator in EC. The study aims to investigate genes associated with endometrial cancer (EC) progression to identify new biomarkers for early detection. Differentially expressed genes (DEGs), Series test of cluster (STC) and protein–protein interaction analyses identified hub genes in EC. Clinical samples were utilized to examine the expression pattern of ECT2, assess its prognostic value, and evaluate its diagnostic potential. Upregulated DEGs were significantly enriched in cancer-related processes and pathways. Validations across databases identified ASPM, ATAD2, BUB1B, ECT2, KIF14, NUF2, NCAPG, and SPAG5 as potential hub genes, with ECT2 exhibiting the highest diagnostic efficacy. The expression levels of ECT2 varied significantly across different clinical stages, pathological grades, and metastasis statuses in UCEC. Furthermore, ECT2 mRNA was upregulated in the p53abn group, indicating a poorer prognosis, and downregulated in the MMRd and NSMP groups, suggesting a moderate prognosis. In clinical samples, ECT2 expression increased from normal endometria and endometrial hyperplasia without atypia (EH) to atypical endometrial hyperplasia (AH) and EC, effectively distinguishing between benign and malignant endometria. High ECT2 expression was associated with an unfavourable prognosis. ECT2 expression significantly rises in AH and EC, showing high accuracy in distinguishing between benign and malignant endometria. ECT2 emerges as a promising biomarker for diagnosing endometrial neoplasia and as a prognostic indicator in EC.