Forkhead box protein O1 (FOXO1) and paired box gene 3 (PAX3) overexpression is associated with poor prognosis in patients with cervical cancer

Int J Clin Oncol. 2019 Nov;24(11):1429-1439. doi: 10.1007/s10147-019-01507-w. Epub 2019 Jul 13.

Abstract

Purpose: Forkhead box protein O1 (FOXO1) and paired box gene 3 (PAX3) have been reported to play an imported role in human cancers, but their role in cervical cancer has not yet been clarified. In this study, we evaluated the functional role of FOXO1 in cervical cancer cells and investigated the expression and clinical significance of FOXO1 and PAX3 in cervical lesions.

Methods: In vitro assessment of cell function by cell viability, migration, and invasion assays were performed on FOXO1-knockdown cervical cancer cells. Immunohistochemical (IHC) staining analyses of FOXO1 and PAX3 were performed with a tissue microarray (TMA). The clinical significance was evaluated by comparing the data with various clinicopathologic characteristics, including survival of patients with cervical cancer.

Results: In vitro results revealed that knockdown of FOXO1 is associated with decreased cell viability (p < 0.001), migration (p < 0.001), and invasion (p < 0.05), supporting the oncogenic role of FOXO1 in cervical cancer. FOXO1 and PAX3 expression was significantly higher in CIN (both p < 0.001) and cancer tissue (both p < 0.001) than in normal tissue. Multivariate analysis indicated that FOXO1 expression (hazard ratio 4.01 [95% CI 1.22-13.10], p = 0.021) and an advanced FIGO stage (hazard ratio 3.89 [95% CI 1.35-11.19], p = 0.012) were independent prognostic factors for overall survival.

Conclusions: This study reveals increased FOXO1 and PAX3 expression in cervical cancers and indicates an oncogenic role of FOXO1 in cervical cancer cells that correlates with poor patient survival.

Keywords: Biomarker; Cervical cancer; FOXO1; PAX3; Prognosis; Tissue microarray.

MeSH terms

  • Aged
  • Cell Line, Tumor
  • Cell Movement / genetics
  • Cell Survival / genetics
  • Female
  • Forkhead Box Protein O1 / genetics*
  • Forkhead Box Protein O1 / metabolism
  • Gene Expression Regulation, Neoplastic
  • Humans
  • Kaplan-Meier Estimate
  • Middle Aged
  • PAX3 Transcription Factor / genetics*
  • PAX3 Transcription Factor / metabolism
  • Prognosis
  • Proportional Hazards Models
  • Tumor Stem Cell Assay
  • Uterine Cervical Dysplasia / genetics
  • Uterine Cervical Dysplasia / pathology
  • Uterine Cervical Neoplasms / genetics*
  • Uterine Cervical Neoplasms / metabolism
  • Uterine Cervical Neoplasms / mortality*

Substances

  • FOXO1 protein, human
  • Forkhead Box Protein O1
  • PAX3 Transcription Factor
  • PAX3 protein, human