Objective To analyze the relationship of serum circRNA-AKT1 and clinicopathological characteristics in cervical cancer patients and its prognostic value.

Methods General data and serum samples were collected from 64 patients with cervical cancer (cervical cancer group), 43 patients with cervical intraepithelial neoplasia (CIN) (CIN group), 22 patients with uterine fibroids (uterine fibroids group), and 81 healthy subjects (control group).The qRT-PCR was used to determine the serum circRNA-AKT1 level of the subjects and the serum circRNA-AKT1 levels were compared among the groups; the ROC curve was performed to evaluate the diagnostic efficacy of circRNA-AKT1 in cervical cancer; the correlation between serum circRNA-AKT1 level and clinicopathological characteristics of cervical cancer patients was analyzed; KM survival curve was utilized to analyze the relationship between serum circRNA-AKT1 and the prognosis of cervical cancer patients; Cox regression was used to analyze the risk factors for poor prognosis in cervical cancer patients.

Results Compared with patients in the control group, the serum circRNA-AKT1 levels of patients in the CIN group and cervical cancer group were increased (P < 0.05);compared with patients in the uterine fibroids group, the serum circRNA-AKT1 levels of patients in the CIN group and cervical cancer group were increased (P < 0.05);compared with patients in the CIN group, the serum circRNA-AKT1 levels of patients in the cervical cancer group were increased (P < 0.05).ROC curve results showed that the AUC for serum circRNA-AKT1 level to diagnosis cervical cancer was 0.931.CircRNA-AKT1 level in serum of cervical cancer patients was showed not to be related to the age, menopausal status, tumor size, or pathological type (P>0.05).Compared with FIGO stage Ⅰ to Ⅱ patients, stage Ⅲ to Ⅳ patients showed elevated proportion of patients with high serum circRNA-AKT1 (P < 0.05);compared with patients without lymph node metastasis, patients with lymph node metastasis exhibited increased proportion of patients with high serum circRNA-AKT1 (P < 0.05).The KM curve showed that the 3-year cumulative survival rate of patients in the circRNA-AKT1 high-expression group (56.4%) was lower than that of patients in the circRNA-AKT1 low-expression group (76.0%), and the difference was statistically significant (χ²=4.01, P < 0.05).Multivariate Cox regression analysis showed that lymph node metastasis, FIGO stage, and circRNA-AKT1 level were risk factors for poor prognosis of cervical cancer patients (P < 0.05).

Conclusions The circRNA-AKT1 is highly expressed in the serum of patients with cervical cancer and is related to lymph node metastasis, clinical stage and patient prognosis.Serum circRNA-AKT1 can serve as an important auxiliary indicator for predicting the prognosis of patients with cervical cancer.