Abstract:
Objective: To explore the relationship and predictive efficacy of serum heat shock protein 70(HSP70), protein kinase D1 (PKD1), chitinase protein 40 (YKL-40) with lymph node metastasis in postmenopausal early endometrial cancer.
Methods: A total of 126 patients with postmenopausal early endometrial cancer admitted to No.980 Hospital of PLA Joint Logistics Support Force from March 2021 to March 2023 were selected as the study group and divided into lymph node metastasis group(
n=22)and non-lymph node metastasis group(
n=104) according to the postoperative pathological diagnosis.Another 114 healthy individuals were selected as the control group.The serum levels of HSP70, PKD1 and YKL-40 in each group were compared.Multivariate logistic regression analysis was used to analyze the factors affecting lymph node metastasis of patients.The receiver operating characteristic (ROC) curve was used to analyze the predictive value of serum HSP70, PKD1 and YKL-40 levels for lymph node metastasis of patients.
Results: The serum levels of HSP70, PKD1 and YKL-40 in the study group were higher than those in the control group (
P< 0.05).The proportion of low differentiation, uterine myometrial infiltration ≥ 50%, and serum levels of CA125, HE4, HSP70, PKD1, and YKL-40 in patients with lymph node metastasis were higher than those in patients without lymph node metastasis (
P< 0.05).Multivariate logistic regression analysis showed that serum HE4, HSP70, PKD1 and YKL-40 levels and uterine myometrial infiltration ≥ 50% were all independent risk factors for lymph node metastasis in patients with postmenopausal early endometrial cancer (all
P< 0.05).The optimal cutoff points for serum HSP70, PKD1, and YKL-40 levels predicting lymph node metastasis in postmenopausal early endometrial cancer patients were 90.82 μg/L, 132.23 μg/L, and 75.32 μg/L, respectively.The sensitivity, specificity, and area under the ROC curve (AUC) of the combined prediction of the three factors were 81.82%, 96.15%, and 0.940, respectively.
Conclusion: The serum levels of HSP70, PKD1 and YKL-40 in patients with early endometrial cancer can be used as sensitive indicators to predict lymph node metastasis, and the combined prediction of the three has a higher prediction efficiency.