Objective: To investigate the role of the SRY-box transcription factor 2 (SOX2) in endometrial carcinoma and the diagnostic value of serum SOX2 levels combined with magnetic resonance imaging (MRI). Methods: The present prospective observational study included 326 cases of endometrial carcinoma. All patients received measurements of serum SOX2 and MRI detection two weeks prior to surgery. Patients' demographic and clinical data including age, BMI, cancer stage, tumor differentiation, invasion, and lymph node metastasis were collected. All patients were followed for 5 years following surgery. Results: Deceased patients showed significantly higher ratios of: FIGO stage III-IV tumors; low tumor differentiation; myometrial invasion depths of >1/2 and cervical invasion. Lymph node metastases and distant metastasis were significantly lower in surviving patients than those in deceased patients. The serum levels of SOX2 were significantly higher in endometrial carcinoma patients compared with the healthy controls and were remarkably higher in deceased patients. Patients with elevated SOX2 levels also had higher rates of FIGO stage III-IV, higher rates of myometrial invasion depth >1/2 and higher rates of low tumor differentiation. Elevated SOX2 levels are correlated with higher rates of lymph node metastases, distant metastases and 5-year mortality. Serum SOX2 levels combined with MRI have the potential to improve the diagnosis of myometrial invasion and lymph node metastasis in endometrial carcinoma. Conclusion: Elevated serum SOX2 levels were associated with poor prognoses of patients with endometrial carcinoma. Serum SOX2 levels combined with MRI could be useful in the diagnosis and prognosis of endometrial carcinoma.
Keywords: MRI; SOX2; diagnosis; endometrial carcinoma; prognosis.