CXCR7, a Prognostic Biomarker in Cervical Squamous Cell Carcinoma, May Be a Screening Index for Treatment Options at Stages IB1 and IIA1
Authors Zhao D, Qin W, Zhao C, Long J, Li M
Received 26 August 2019
Accepted for publication 21 November 2019
Published 9 December 2019 Volume 2019:11 Pages 10287—10296
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 3
Editor who approved publication: Dr Sanjeev Srivastava
Danyang Zhao,1,* Wenban Qin,2,* Chuanxiang Zhao,3 Jianxiong Long,4 Mujun Li1
1Department of Reproductive Center, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, People’s Republic of China; 2Department of Oncology, Chongzuo People’s Hospital, Nanning 530021, Guangxi Province, People’s Republic of China; 3Department of General Surgery, The Second People’s Hospital of Shenzhen, Nanning 530021, Guangxi Province, People’s Republic of China; 4School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi Province, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Jianxiong Long
School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning 530021, Guangxi Province, People’s Republic of China
Department of Reproductive Center, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Road, Nanning, Guangxi 530021, People’s Republic of China
Purpose: Recent studies indicate that CXC chemokine receptor type 7 (CXCR7) is associated with tumorigenesis, progression, and metastasis of various cancers, but its roles and molecular mechanisms of action in cervical squamous cell carcinoma (CSCC) remain unclear. Our purpose was to explore the expression patterns of CXCR7 and epidermal growth factor receptor (EGFR) in CSCC and to identify possible correlations with clinical characteristics. We also tested whether CXCR7 can be a screening index for treatment options for CSCC stages IB1 and IIA1.
Methods: Expression of CXCR7 and EGFR in tumors from 165 patients with CSCC was evaluated by immunohistochemistry and compared with the clinical data including survival.
Results: Patients at CSCC stages IB1 and IIA1 received different treatment options, including radical hysterectomy, pelvic lymph node dissection, and para-aortic lymph node sampling (RH group, 67 patients) or pelvic external-beam radiation therapy with brachytherapy (EBRT group, 34 patients). Disease-free survival (DFS) and overall survival (OS) were compared between two groups at different CXCR7 expression levels. Immunohistochemical staining showed that CXCR7, EGFR, phospho-ERK, and phospho-AKT amounts increased from normal cervical epithelia and cervical intraepithelial neoplasia to CSCC, and CXCR7 was associated with the disease stage, lymph node metastasis, tumor size ≥40 mm, and EGFR expression. Kaplan–Meier analysis revealed that CXCR7 and EGFR expression was associated with shorter DFS and OS. Multivariate analysis suggested that CXCR7 was independently associated with DFS and OS. Prevalence of recurrence and distant metastasis was significantly lower in the EBRT group than in the RH group during CXCR7 expression. Besides, CXCR7 knockdown significantly decreased the proliferation and invasion of CSCC cells.
Conclusion: CXCR7 is coexpressed with EGFR, which may be involved in ERK or AKT pathway activation. CXCR7 may be a screening index for treatment options at CSCC stages IB1 and IIA1.
Keywords: CXC chemokine receptor type 7, cervical cancer, cancer treatment protocol
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