Zhang Fengxia, Ma Zengguang, Zhang Fengqin, Li Yucui, Liu Xiaojie, Zhang Jiandong
Medical Laboratory Center, Hengshui Health Technology Vocational College, Hengshui, China.
Respiratory and Critical Care Medicine Department, Hengshui Third People's Hospital, Hengshui, China.
Iran J Med Sci. 2025 Aug 1;50(8):539-547. doi: 10.30476/ijms.2025.103065.3620. eCollection 2025 Aug.
Exosomal molecules derived from cancer cells have been recognized as candidate biomarkers for cancer diagnosis and prognosis. This study aimed to evaluate the potential of the LDH-C4 expression level in cervical carcinoma.
A retrospective study was conducted on patients with cervical carcinoma at the Third Hospital of Hebei Medical University, in Shijiazhuang, China, between July 2021 to September 2023. Peripheral blood was obtained, and serum and exosomes were extracted. Lactate dehydrogenase (LDHC) gene expression levels were quantified using reverse transcription-quantitative polymerase chain reaction (PCR), and these were compared with protein expression levels in cervical carcinoma tissues. Statistical analyses, including independent t tests, Chi square tests, receiver operator characteristic (ROC) curves, Kaplan-Meier analysis, and subsequent log-rank tests, were performed with the SPSS software version 21. Univariate and multiple analyses were used to analyze independent prognostic risk factors. P<0.05 was considered statistically significant.
A total of 220 individuals were recruited, including 120 with cervical carcinoma and 100 healthy controls. In patients with cervical carcinoma, the LDHC gene expression levels were 5.58% and 11.28% in serum and exosomes of healthy donors and were 79.38% and 66.27% in patients with cervical carcinoma. There was a statistically significant difference in the LDHC expression between the patient group and the control group (P=0.008, in serum; P=0.011, in exosomes). In addition, LDH-C4 protein expression was associated with histology grade (P=0.022), tumor stage (P=0.019), and lymph node metastasis (P=0.016). The overall survival of patients with cervical carcinoma with positive LDH-C4 expression was 83.54%; patients with a higher LDH-C4 expression exhibited a poorer overall survival rate than those with lower LDH-C4 expression. Multiple Cox regression analysis demonstrated that LDH-C4 expression is a poor independent prognostic factor for patients with cervical carcinoma.
LDH-C4 levels in serum and exosomes may exhibit potential in identifying patients with cervical carcinoma, thus providing a novel approach for the early screening of cervical carcinoma.
源自癌细胞的外泌体分子已被视为癌症诊断和预后的候选生物标志物。本研究旨在评估乳酸脱氢酶C4（LDH-C4）表达水平在宫颈癌中的潜力。
对2021年7月至2023年9月期间在中国石家庄河北医科大学第三医院的宫颈癌患者进行了一项回顾性研究。采集外周血，提取血清和外泌体。使用逆转录定量聚合酶链反应（PCR）对乳酸脱氢酶（LDHC）基因表达水平进行定量，并将其与宫颈癌组织中的蛋白质表达水平进行比较。使用SPSS 21版软件进行统计分析，包括独立t检验、卡方检验、受试者操作特征（ROC）曲线、Kaplan-Meier分析以及随后的对数秩检验。采用单因素和多因素分析来分析独立的预后危险因素。P<0.05被认为具有统计学意义。
共招募了220名个体，包括120名宫颈癌患者和100名健康对照。在宫颈癌患者中，健康供体血清和外泌体中的LDHC基因表达水平分别为5.58%和11.28%，而宫颈癌患者中的表达水平分别为79.38%和66.27%。患者组和对照组之间的LDHC表达存在统计学显著差异（血清中P = 0.008；外泌体中P = 0.011）。此外，LDH-C4蛋白表达与组织学分级（P = 0.022）、肿瘤分期（P = 0.019）和淋巴结转移（P = 0.016）相关。LDH-C4表达阳性的宫颈癌患者的总生存率为83.54%；LDH-C4表达较高的患者的总生存率低于LDH-C4表达较低的患者。多因素Cox回归分析表明，LDH-C4表达是宫颈癌患者不良的独立预后因素。
血清和外泌体中的LDH-C4水平可能在识别宫颈癌患者方面具有潜力，从而为宫颈癌的早期筛查提供一种新方法。
