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Serum Circular FoxO3a Serves as a Novel Prognostic Biomarker in Squamous Cervical Cancer

Authors Tang X, Liu S, Ding Y, Guo C, Guo J, Hua K, Qiu J

Received 22 December 2019

Accepted for publication 27 February 2020

Published 9 April 2020 Volume 2020:12 Pages 2531—2540


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Antonella D'Anneo

Xiaoyan Tang,1– 3,* Songping Liu,4,* Yan Ding,1– 3,* Chenyan Guo,1– 3 Jingjing Guo,1– 3 Keqin Hua,1– 3 Junjun Qiu1– 3

1Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, People’s Republic of China; 2Department of Obstetrics and Gynecology of Shanghai Medical College, Fudan University, Shanghai 200032, People’s Republic of China; 3Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai 200011, People’s Republic of China; 4Department of Obstetrics and Gynecology, Zhenjiang Maternal and Child Health Hospital, Zhenjiang, Jiangsu 212001, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Junjun Qiu; Keqin Hua
Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, 419 Fangxie Road, Shanghai 200011, People’s Republic of China
Tel +86-21-63455050 Ext 8261
Fax +86-21-63455090

Purpose: Circular RNAs (circRNAs) are novel type of noncoding RNAs that play important roles and serve as noninvasive biomarkers in various cancers. In the present study, we focused on circFoxO3a and aimed to investigate its prognostic value as a novel serum biomarker for squamous cervical cancer (SCC).
Patients and Methods: Our study included 103 SCC patients from Obstetrics and Gynecology Hospital of Fudan University. Expression levels of circFoxO3a in the serum of patients with SCC were examined by reverse transcription‑quantitative PCR (RT‑qPCR). The correlation between serum circFoxO3a expression and clinicopathologic factors was analyzed. The Kaplan–Meier method and multivariate Cox regression analysis were applied to evaluate the independent prognostic factors for SCC. A prognostic predictive nomogram was constructed using R software.
Results: Levels of serum circFoxO3a were decreased in SCC patients compared with controls. Low expression of circFoxO3a was correlated with deeper stromal invasion and positive lymph node metastasis. Moreover, SCC patients with lower expression of serum circFoxO3a showed poorer prognosis, including both overall survival (OS) and recurrence-free survival (RFS). Multivariate Cox analysis indicated low serum circFoxO3a levels to be an unfavorable prognostic factor for both OS and RFS, independent of positive lymph node metastasis. Notably, the predictive nomogram we established further confirmed that serum circFoxO3a is a useful tool for predicting survival in SCC.
Conclusion: Altogether, our findings demonstrated that serum circFoxO3a could serve as a potential novel noninvasive predictive prognostic biomarker and therapeutic target for SCC.

Keywords: circular RNA, FoxO3a, squamous cervical cancer, biomarker

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