Diagnostic and prognostic values of serum insulin-like growth factor binding protein 4 expression in cervical cancer.

Objective: Insulin-like growth factor binding protein 4 (IGFBP4) is lowly expressed in cervical cancer (CC) cells. However, it remains unclear about its expression and diagnostic and prognostic values in CC. Therefore, this research probed the serum expression of IGFBP4 in CC patients and its diagnostic and prognostic values.

Methods: This study prospectively included 146 CC patients admitted to our hospital (the CC group) from January 2018 to June 2020 and 146 patients with cervical intraepithelial neoplasia (CIN) admitted to the hospital (the CIN group) and 146 normal women receiving health checkups during the same period (the normal group). Serum IGFBP4 expression in CC patients was detected with quantitative reverse transcription-polymerase chain reaction. Receiver-operating characteristic (ROC) curves were utilized to evaluate whether serum IGFBP4 expression could assist in predicting CC occurrence. Kaplan-Meier survival analysis and Cox regression analysis were utilized to assess the significance of serum IGFBP4 expression in the prognosis of CC patients.

Results: IGFBP4 was downregulated in serum from CIN and CC patients, with lower expression in CC patients. Marked differences were noted in histologic differentiation, FIGO stage, and lymph node metastasis between the high and low IGFBP4 expression groups. The area under the ROC curve of serum IGFBP4 expression to assist in CC diagnosis was 0.9206 (cut-off, 0.8450; sensitivity, 86.30%; specificity, 81.51%). Low serum expression of IGFBP4 augmented the risk of poor prognosis in CC patients and was an independent risk factor for poor prognosis.

Conclusion: Low serum expression of IGFBP4 can assist in CC diagnosis and is an independent risk factor for the dismal prognosis of CC patients.