Serous and Exosomal LDH-C4 as a Potential Diagnostic and Prognostic Biomarker of Cervical Carcinoma.

Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.