The aim of this work was to explore the novel and promising biomarkers for the diagnosis and prognosis of cervical cancer patients.
The secretome of primary cervical tissues was extracted and then determined by the LC-MS/MS assay. The level of screened targets was confirmed using the RT-PCR and ELISA in cervical cancer tissue samples. The median expression level of certain targets was used as a cutoff value to divide the patients into 2 groups, and then the patients were followed up. The predictive abilities of the targets on the prognosis were further studied.
LC-MS/MS, together with bioinformatic analysis, demonstrated that totally 95 targets were dysregulated in cervical cancer. Among them, ECM2, KLK6, and MASP1 were increased in cervical cancer in a stage-dependent manner, whereas FGA was negatively associated with the stage of cervical cancers. Overall survival (OS) and disease-free survival (DFS) rates were significantly decreased in the KLK6 high group, whereas little difference was found between the high and low groups of other 3 cases. Univariate analysis of the 5-year OS and DFS revealed a significantly worse outcome for patients with KLK6 high tumors. In multivariate analysis, KLK6 remained a highly significant prognostic marker for OS and DFS. Combined survival analysis of KLK6 expression and the HPV infection revealed that KLK6highHPV(-) predicted the most poor OS rate and the KLK6lowHPV(+) group showed the best prognosis.
Through the secretome analysis, we identified a series of secreted proteins differentially expressed in the clinical cancer, among which KLK6 has the potential to become a promising biomarker for the diagnosis and prognosis of cervical cancer patients.

© 2020 S. Karger AG, Basel.