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Our work is a retrospective study from the year 2010 November until June 2016, it covers 517 patients who were consulted and diagnosed positive for cancer of the endometrium in the Department of Gynecology of the first affiliated hospital of Chongqing Medical University. Objective: To determine the efficiency of biomarkers or preoperative features to predict type II endometrial cancer (EC) preoperatively. Methods: 517 patients with EC admitted and undergone surgery in our hospital from November 2010 to June 2016 was collected. Preoperative serum CA125, HE4, CA19-9 and CK19 were measured by electrochemiluminescence immunoassay and ROMA (Risk of Ovarian Malignancy Algorithm) index was calculated. Results: (1) Tumor diameter≥2cm (P=0.001, OR=7.020, 95%CI 2.202-22.382) and age >40 years old (P=0.036, OR=9.646, 95%CI 1.155-80.581) were testified to predict the likelihood of type II EC in premenopausal patients. And for postmenopausal patients, HE4>140pmol/L (P=0.004, OR=16.337, 95%CI 2.432-109.719) and age >60 years old (P=0.006, OR=2.640, 95%CI 1.318-5.286) were confirmed independent risk factors of type II EC. (2)Type II cancer had a worse PFS and OS than type I cancer. Conclusions: Tumor size (≥2cm) or age (＞40 years old) would be an alert for those premenopausal patients who desire preserving ovaries. On the other hand, for those postmenopausal patients with preoperative histology undetermined while with HE4 ＞140pmol/L or 60 years or even older, complete and systemic staging surgery should be considered.