Abstract:

Objective To investigate the clinical application roles of serum β-Klotho and nestin-1 in the auxiliary diagnosis and clinical staging of endometrial cancer. Methods A total of 140 patients with endometrial cancer（endometrial cancer group），140 patients with benign uterine diseases（benign disease group） and 140 healthy females（healthy control group） were enrolled from Tangshan Maternal and Child Health Hospital from March 2019 to March 2020. According to the International Federation of Gynecology and Obstetrics staging criteria，they were classified into stage Ⅰ-Ⅱ group（88 cases） and stage Ⅲ-Ⅳ group（52 cases）. The clinical data were collected，and the levels of serum β-Klotho and nestin-1 were determined in endometrial cancer group before and after surgery，benign disease group and healthy control group. Pearson correlation analysis was used to evaluate the correlation between serum β-Klotho and nestin-1 in patients with endometrial cancer. Multivariate Logistic regression analysis was used to evaluate the influencing factors of clinical staging in patients with endometrial cancer. Receiver operating characteristic（ROC） curve was used to evaluate the efficacy of serum β-Klotho and nestin-1 in the auxiliary diagnosis of endometrial cancer and the judgment of clinical staging. Results The levels of serum β-Klotho in endometrial cancer group before surgery，benign disease group and healthy control group were increased successively（P<0.001），and the levels of serum nestin-1 were decreased successively（P<0.001）. The levels of serum β-Klotho in endometrial cancer group after surgery were higher than those before surgery（P<0.05），and the levels of serum nestin-1 were lower than those before surgery（P<0.05）. Compared with the stage Ⅰ-Ⅱ group，the proportions of poorly differentiation，lymphatic metastasis and myometrial invasion depth>1/2 and the level of serum nestin-1 in the stage Ⅲ-Ⅳ group were increased（P<0.05），and the level of serum β-Klotho was decreased（P<0.05）. There was no statistical significance in the other data between the 2 groups（P>0.05）. Poorly differentiation，myometrial invasion depth>1/2，elevated nestin-1 and decreased β-Klotho were all risk factors for stage Ⅲ-Ⅳ endometrial cancer（P<0.05）. The areas under curves（AUC） of serum β-Klotho and nestin-1 for the auxiliary diagnosis of endometrial cancer were 0.744，0.822 and 0.870，respectively，and the AUC for the judgment of clinical stage Ⅲ-Ⅳ in endometrial cancer patients were 0.714，0.800 and 0.861，respectively. Conclusions The levels of serum β-Klotho and nestin-1 in patients with endometrial cancer are abnormal，which may be used as indicators for the auxiliary diagnosis and clinical staging of endometrial cancer.

Key words: β-Klotho, Nestin-1, Endometrial cancer, Clinical staging