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Increased Serum Calcium Level Promotes the Risk of Lymph Node Metastasis in Endometrial Cancer

Authors Li XC, Dong YY, Cheng Y, Zhou JY, Yang X, Shen BQ, Wu XT, Li XP, Wang JL

Received 14 March 2020

Accepted for publication 25 May 2020

Published 25 June 2020 Volume 2020:12 Pages 5023—5030


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Harikrishna Nakshatri

Xing-Chen Li,1,* Yang-Yang Dong,1,* Yuan Cheng,1 Jing-Yi Zhou,1,2 Xiao Yang,1 Bo-Qiang Shen,1 Xiao-Tong Wu,1,2 Xiao-Ping Li,1 Jian-Liu Wang1,2

1Department of Obstetrics and Gynecology, Peking University People’s Hospital, Beijing 100044, People’s Republic of China; 2Beijing Key Laboratory of Female Pelvic Floor Disorders Diseases, Beijing 100044, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Jian-Liu Wang
Department of Obstetrics and Gynecology, Peking University People’s Hospital, Beijing 100044, People’s Republic of China
Tel +86 10 8832 4474

Purpose: The early predictive values of diagnostic markers for lymph node metastasis (LNM) in endometrial cancer (EC) are still unclear at present. The purpose of this study is to explore the relationship between serum calcium and LNM in EC.
Methods: We identified all patients with EC who underwent surgery between January 2012 and December 2016. Patient characteristics and various preoperative clinicopathologic data were obtained from medical records and were reviewed retrospectively. These patients were divided into two groups according to the pathology of their lymph node. Logistic regression models analyzed the relationship between the ionized calcium and LNM of EC patients, while adjusting for the potential confounders.
Results: A total of 448 patients were assessed. Univariate analysis showed that ionized calcium, CA125 level, tumor grade, peritoneal cytology, FIGO stage, histological type, LVSI, and myometrial invasion were positively correlated with LNM (all P< 0.05). The risk of LNM increased with the promotion of serum ionized calcium (P for trend < 0.01). Ionized calcium level was significant before and after the adjustment of cofounders (unadjusted: OR=11.9, 95% CI: 4.8– 29.6, P< 0.01; model I: OR=11.3, 95% CI: 4.5– 28.8, P< 0.01; model II: OR=5.2, 95% CI: 1.6– 17.2, P< 0.05). Additionally, the risk of ionized calcium was especially evident in patients whose age was older than 60, BMI< 28 kg/m2, grade 3, negative peritoneal cytology and endometrioid endometrial adenocarcinoma.
Conclusion: Ionized calcium level was highly associated with LNM in EC and acted as a potential biomarker in predicting the risk of LNM in EC.

Keywords: serum calcium level, EC, lymph node metastasis, stratification analysis

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