Abstract
Objectives: Explore the diagnostic and prognostic value of cyclooxygenase-2 and wnt3a/β-catenin pathway in endometrial cancer.Methods: A prospective cohort study of 93 women underwent hysterectomy at the China-Japan Friendship Hospital (61 patients with primary endometrial carcinoma, and 32 control patients with uterine prolapse or leiomyoma of uterus). Cox2 and β-catenin expression were determined by immunohistochemistry. The serum levels of cox2 and wnt3a were detected via ELISA assays.Results: Patients with endometrial cancer showed overexpression of cox2 and β-catenin, as well as significantly higher serum levels of cox2 and wnt3a. The serum cox2 level, which is highly significant in predicting the risk of disease progression (RR, 9.617, 95% confidence interval, 1.162–79.622, P = 0.036), showed good diagnostic and prognostic potential, with cut-off of 55 U/L, but alongside β-catenin expression in tissues, were related to poor prognosis (RR, 12.426; 95% confidence interval, 1.618–95.450; P = 0.015).Conclusion: Serum levels of cox2 and wnt3a exhibited diagnostic value for endometrial cancer. Cox2 serum levels and β-catenin expression also showed potential value of prognostic prediction. Cox2 serum levels might be a potential marker for early diagnosis and prognosis prediction in endometrial cancer.
Highlights
Endometrial cancer (EC), accounting for 20–30%, is one of the three major female genital tract malignancies [1, 2]
No significant differences were observed in menopausal status, cesarean history, dysmenorrhea history, diabetes, and arterial hypertension as well (P > 0.05) (Table 1)
Our study showed that cox2 serum levels with a cut-off value of 55 U/L were a better predictor of early EC diagnosis, FIGURE 3 | Kaplan-Meier curves for progression-free survival (PFS) and hazard ratios for tumor progression. (A) Comparison of Progression Free Survival (PFS) between cox2 positive group and the negative group. (B) Comparison of PFS between β-catenin positive group and negative group. (C) Comparison of PFS in endometrial cancer patients between those with cox2 serum levels < 55 U/L and those with cox2 serum levels ≥ 55 U/L. (D) PFS in patients with wnt3a serum levels < 25 ng/ml vs patients with wnt3a serum levels ≥ 25 ng/ml. (E) Odds ratio (OR) for diagnosis. (F) Relative Risk (RR) for disease progression
Summary
Endometrial cancer (EC), accounting for 20–30%, is one of the three major female genital tract malignancies [1, 2]. Most of them occurs in women aged 55–65 years, but was recently diagnosed in younger women [2]. EC is divided into two types based on its dependence on estrogen, type I—estrogen-dependent cancer and type II—estrogen independent cancer [2, 3]. The overall survival rate for EC patients is yet to improve, with 288,000 new cases diagnosed and 74,000 deaths registered each year worldwide [4]. Identification of clinically prognostic risk factors is crucial to enhance the survival rate of EC patients. Diagnostic and Prognostic Predicting Effect of Cox
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