Wei Wang, Yi Zhang

Department of Gynecology, The First Affiliated Hospital of China Medical University, Shenyang, 110000, People’s Republic of China

Correspondence: Yi Zhang, Department of Gynecology, The First Affiliated Hospital of China Medical University, No. 155, Nanjing North Street, Heping District, Shenyang City, Liaoning Province, 110000, People’s Republic of China, Tel +86 24 83283516, Email zhangyi1836@126.com

Objective: To investigate the factors affecting lymph node metastasis (LNM) in patients with cervical cancer and the predictive efficacy of serum tyrosine kinase receptor 1 (Tie-1), serum Forkhead Framing Protein O3a (FoxO3a), and protein kinase D1 (PKD1).
Methods: Cervical cancer patients were categorized into 60 cases of LNM-positive group and 320 cases of LNM-negative group according to whether LNM occurred or not. The levels of serum Tie-1, FoxO3a and PKD1 were tested. Multivariate logistic regression analysis was conducted to identify the risk factors for cervical cancer induced lymph node metastasis (LNM). Receiver operating characteristic (ROC) curves were plotted to analyze the predictive value of various indicators for LNM in cervical cancer.
Results: The percentage of patients with FIGO stage IIa, combined paracervical infiltration and myometrial infiltration was significantly higher in the LNM-positive group than in the LNM-negative group (P< 0.05). Huanz serum levels of Tie-1 and PKD1 in the LNM-positive group were significantly higher than those in the LNM-negative group, and the relative expression of FoxO3a was significantly lower than that in the LNM-negative group (P< 0.05). The results of logistic regression analysis showed that FIGO stage, parietal infiltration, myometrial infiltration, serum Tie-1, PKD1 were LNM-positive in cervical cancer patients (P< 0.05), and low level of relative expression of serum FoxO3a was a protective factor (P< 0.05). The cutoff of serum Tie-1, FoxO3a, and PKD1 levels for predicting the occurrence of LNM in cervical cancer were 1.97 ng/mL, 0.54, and 113.26 μg/L, and the area under the ROC curve (AUC) was 0.852, 0.827, 0.844, respectively.
Conclusion: Serum Tie-1, FoxO3a and PKD1 have certain predictive efficacy for lymph node metastasis, and the combination of these tests can improve the predictive accuracy.

Keywords: cervical cancer, lymph node metastasis, Tie-1, FoxO3a, PKD1, predictive efficacy