<p>Increased Serum Calcium Level Promotes the Risk of Lymph Node Metastasis in Endometrial Cancer</p>

Abstract

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/m 2 , 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.

Calcium and TRPV4 promote metastasis by regulating cytoskeleton through the RhoA/ROCK1 pathway in endometrial cancer

“…Our previous work demonstrated that increased ionized calcium promoted the metastasis of peritoneal tumor cells and lymph node metastasis in EC 4,5 , a finding in keeping with other evidence that cytosolic free calcium concentration played an important role in the regulation of downstream cellular functions in cancer 6 . The elevation of calcium concentration was commonly seen in paraneoplastic or bone-metastatic tumors, but seldom in other tumors.…”

Women who develop ovarian cancer show an increase in serum calcium and a decrease in serum albumin. A longitudinal study in the Janus Serum Bank Cohort

“…The stability of ionized calcium contributes to the stability of total serum calcium, of which 50% is ionized. Higher ionized calcium levels recently were reported in association with lymph node metastases among women with endometrial cancer, a malignancy that shares pathophysiologic features with ovarian cancer [[ 18 ] [ 19 ]].…”

Calcium and calcium-related proteins in endometrial cancer: opportunities for pharmacological intervention

“…Calcium ions are ubiquitous intracellular messengers that regulate a myriad of cellular processes and can affect cell survival. Our previous studies have identified serum calcium ion level as a potential predictor for lymph node metastasis and positive peritoneal cytology in endometrial cancer, suggesting that calcium ions participate in the progression of EC [2,3].…”