Abstract: OBJECTIVE： To determine expression levels of the serum keratin 17 (KRT17) protein in patients with locally advanced cervical cancer (LACC) and its impact on response to neoadjuvant chemotherapy (NACT). METHODS： From January 2017 to June 2018， 70 cervical cancer patients who visited our hospitalwere selected and they were treated with arterial interventional neoadjuvant chemotherapy combined with surgery. Before treatment， their serum KRT17 protein expression levels were measured by enzyme-linked immunosorbent assay (ELISA). According to the median level，they were divided into low expression and high expression groups. The progression free survival (PFS)， total survival (OS)， pelvic progression free survival (PPFS)，and pelvic progression free survival (PPFS) of the two groups of patients were compared to evaluate changes in the expression levels and in clinical significance with chemotherapy. There was a difference in distant metastasis free survival (DMFS). RESULTS： The median serum KRT17 level in LACC patients was 0.65 μg/L，and the range was 0.49-1.26 μg/L. There were 33 patients in the low expression group and 36 in the high expression group. The area under the subject operating characteristic (ROC) curve (AUC) of serum KRT17 for predicting the efficacy of NACT in the patients was 0.897 [95%CI (0.816，0.978)]，with sensitivity and specificity of 90.6% and 81.6%，respectively. The median PFS of patients with low and high expression of serum KRT17 was 57.23 and 48.75 months， respectively； The median OS was 58.1 and 55.5 months， respectively； The median PPFS was 56.9 and 49.9 months， respectively； The median DMFS was 57.1 and 50.1 months， respectively. The Kaplan Meier survival curve shows a positive correlation between increased serum KRT17 expression and shortened PFS， OS， PPFS， and DMFS in LACC patients. CONCLUSION： Expression of KRT17 protein in the serum of LACC patients was elevated，and the elevated levels can be a useful predictor for poor prognosis in LACC patients who were treated with NACT.

Key words: keratin 17, locally advanced cervical cancer, neoadjuvant chemotherapy, arterial interventional chemotherapy, curative effect