Abstract
PURPOSE: Apo10 and TKTL1 are tumor-associated markers reflecting impaired apoptosis and enhanced glycolysis respectively. This study aimed to evaluate the diagnostic potential of Apo10, TKTL1, and APT (a combination of Apo10 and TKTL1) in screening early-stage cervical cancer. METHODS: A total of 152 patients with cervical cancer and 152 age-matched healthy controls were enrolled at Sun Yat-sen University Cancer Center from November 2020 to August 2023. Clinical data were collected from the Hospital Information System (HIS) and medical records, and blood samples were collected from all participants before treatment using epitope detection in monocytes (EDIM) technology 60 min after their last meal. Descriptive statistics and receiver operating characteristic (ROC) curves were used to compare the diagnostic performance of Apo10, TKTL1, and APT to those of conventional cervical cancer biomarkers (CEA, CA125, and SCC-A). RESULTS: Most of the enrolled patients with cervical cancer had early-stage disease (70%) and squamous cell histology (84.9%). The Apo10, TKTL1, and APT levels were significantly higher in the cervical cancer group than in the control group (Apo10:139 vs. 132, TKTL1:121 vs. 114, APT: 260 vs. 246). We also found that Apo10, TKTL1, and APT showed superior diagnostic performance (AUC: 0.864, 0.865, 0.905) compared to traditional markers (CEA: 0.690, CA125: 0.594, SCC-A: 0.806). Sensitivity analysis revealed APT maintained high diagnostic value across tumor stages and in both HPV-negative (AUC = 0.967) and TCT-negative (AUC = 0.958) subgroups. CONCLUSION: Apo10, TKTL1, and APT outperform conventional biomarkers in detecting cervical cancer and may serve as reliable diagnostic indicators.