The predictive value of serum CCL20 and FOXD1 for relapse and metastasis in cervical cancer patients after radiotherapy and chemotherapy

Gao Lei; Yuan Xiangkun; Hu Jianwei; Zhang Yongxia; Miao Junjun; Tian Dandan; Hou Guangying; Chen Yuanyuan; Wang Qingwen; Wang Xi

doi:10.16689/j.cnki.cn11-9349/r.2026.03.014

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Electronic Journal of Metabolism and Nutrition of Cancer ›› 2026, Vol. 13 ›› Issue (3) : 421-427. DOI: 10.16689/j.cnki.cn11-9349/r.2026.03.014

Original Articles

The predictive value of serum CCL20 and FOXD1 for relapse and metastasis in cervical cancer patients after radiotherapy and chemotherapy

Gao Lei, Yuan Xiangkun, Hu Jianwei, Zhang Yongxia, Miao Junjun, Tian Dandan, Hou Guangying, Chen Yuanyuan, Wang Qingwen, Wang Xi

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Abstract

Objective To explore the predictive value of serum chemokine ligand 20 (CCL20) and forkhead box D1 (FOXD1) for relapse and metastasis in cervical cancer patients after radiotherapy and chemotherapy. Method From March 2021 to February 2024, 134 patients with cervical cancer who underwent radiotherapy and chemotherapy in Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine, Hebei Province were designated as the study group. They were grouped into a relapse group (n=38) and a non-relapsing group (n=96) based on whether they had relapse or metastasis. Meanwhile, 130 patients with benign cervical lesions were served as the lesion group. Another 100 healthy individuals who underwent physical examination were served as the control group. ELISA method was used to detect serum CCL20 and FOXD1. The clinical pathological features, as well as serum CCL20 and FOXD1, were compared between the relapse and non-relapsing groups. Multivariate logistic regression was used to explore the influencing factors of relapse and metastasis in cervical cancer patients after radiotherapy and chemotherapy. ROC curve was used to explore the predictive value of serum CCL20 and FOXD1 for relapse and metastasis in cervical cancer patients after radiotherapy and chemotherapy. Decision curve (DCA) analysis for predicting the clinical value of the model. Result Serum CCL20 and FOXD1 levels showed a gradient increase (study group> lesion group> control group, P<0.05). The relapse group had higher proportions of tumor stage Ⅳ, lymph node metastasis, infiltration depth ≥1/2, and levels of serum CCL20 and FOXD1 than the non-relapse group (P<0.05). All these factors were independent risk factors for recurrence and metastasis after chemoradiotherapy (P<0.05). The area under the curve (AUC) values of serum CCL20, FOXD1, and their combination in predicting relapse and metastasis in cervical cancer patients after radiotherapy and chemotherapy were 0.844, 0.859, and 0.936, respectively. The combination was better than the individual predictions (Z _{combination - CCL20}=2.887, Z _{combination - FOXD1}=2.241, P=0.004, P=0.025). The results of DCA curve analysis showed that when the high-risk threshold was 0.04 to 0.98, the net benefit rate of the combined prediction of serum CCL20 and FOXD1 for recurrence and metastasis of cervical cancer patients after radiotherapy and chemotherapy was higher than that predicted by a single indicator. Conclusion The expression levels of CCL20 and FOXD1 in the serum of cervical cancer patients were significantly elevated, and the combined detection may have higher predictive value for recurrence and metastasis after chemoradiotherapy in cervical cancer patients.

Key words

Cervical cancer / Chemokine ligand 20 / Forkhead box D1 / Radiotherapy and chemotherapy / Relapse / Metastasis / Measurement value / Prognosis

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Gao Lei, Yuan Xiangkun, Hu Jianwei, Zhang Yongxia, Miao Junjun, Tian Dandan, Hou Guangying, Chen Yuanyuan, Wang Qingwen, Wang Xi. The predictive value of serum CCL20 and FOXD1 for relapse and metastasis in cervical cancer patients after radiotherapy and chemotherapy[J]. Electronic Journal of Metabolism and Nutrition of Cancer. 2026, 13(3): 421-427 https://doi.org/10.16689/j.cnki.cn11-9349/r.2026.03.014

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