title: Weak expression of focal adhesion kinase (pp125FAK) in patients with cervical cancer is associated with poor disease outcome.
abstract: OBJECTIVE
  The pp125 focal adhesion kinase (FAK) plays a pivotal role in tumor cell signaling. FAK expression has been linked to tumor cell invasion and metastasis, but data on cervical cancer are inconclusive. Our goal was to investigate FAK expression in cervical cancer and to assess whether its expression correlates with prognosis.
  
  
  METHODS
  FAK expression was examined using immunohistochemistry with sections from 162 resected cervical cancer specimens. Kaplan-Meier survival curves were used to determine the significance of FAK expression in the prognosis of cervical cancer patients.
  
  
  RESULTS
  Specific FAK expression was found in the tumor cells, whereas normal cervical epithelium showed barely any FAK expression. Of 162 invasive cervical cancer specimens, 55 (34%) revealed weak expression of FAK, whereas moderate and strong expression was found in 63 (39%) and 44 (27%) tumors, respectively. Patients with tumors expressing weak amounts of FAK were characterized by a significantly poorer overall survival compared with those with moderate and high intratumoral FAK expression (P = 0.002). Weak expression of FAK correlated with pelvic lymph node metastasis (P = 0.026) and recurrent disease (P = 0.013). Multivariate Cox regression analysis revealed decreased FAK expression and pelvic lymph node metastasis to be significant independent factors predictive of poor disease outcome (hazard ratio, 0.36; P = 0.005; hazard ratio, 2.38; P = 0.018, respectively).
  
  
  CONCLUSIONS
  Weak expression of FAK in invasive cervical cancer is a strong independent predictor of poor patient outcome. Further studies are warranted to elucidate whether FAK expression analysis is a suitable tool identifying patients at high risk even at an early clinical stage.
authors.affiliation: Departments of Obstetrics and Gynecology and Pathology, Freiburg University Medical Center, Freiburg, Germany. bGabriel@frk.ukl.uni-freiburg.de
authors.forename: Boris
authors.initials: B
authors.lastname: Gabriel
authors.forename: Axel
authors.initials: A
authors.lastname: zur Hausen
authors.forename: Elmar
authors.initials: E
authors.lastname: Stickeler
authors.forename: Carola
authors.initials: C
authors.lastname: Dietz
authors.forename: Gerald
authors.initials: G
authors.lastname: Gitsch
authors.forename: Dagmar-C
authors.initials: DC
authors.lastname: Fischer
authors.forename: Jiri
authors.initials: J
authors.lastname: Bouda
authors.forename: Clemens
authors.initials: C
authors.lastname: Tempfer
authors.forename: Annette
authors.initials: A
authors.lastname: Hasenburg
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D051417:Focal Adhesion Kinase 1 / Q000096:biosynthesis*; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D011379:Prognosis; D016019:Survival Analysis; D002583:Uterine Cervical Neoplasms / Q000201:enzymology / Q000378:metabolism / Q000473:pathology*
chemical_list: D051417:Focal Adhesion Kinase 1; C496050:PTK2 protein, human