Decreased expression of EIF4A1 after preoperative brachytherapy predicts better tumor-specific survival in cervical cancer.
OBJECTIVE
The aim of this study is to investigate whether EIF4A1, EIF4E, and EIF4G1 can serve as prognostic markers for patients with cervical cancer receiving preoperative brachytherapy.


METHODS
Tissue microarrays composed of 35 normal cervix samples, 87 cervical cancers treated without preoperative therapy, and 50 pairs of cervical cancer tissues collected before and after preoperative brachytherapy were constructed and evaluated for the expression of EIF4A1, EIF4E, and EIF4G using immunohistochemistry. Immunohistochemical staining was scored by the staining intensity and the percentages of tumor cells. The χ test was used to analyze the association between the immunohistochemistry results and clinicopathologic variables. The Kaplan-Meier method was applied to analyze the disease-specific survival.


RESULTS
Overexpression of EIF4A1, EIF4E, and EIF4G1 were detected in 83.9%, 84.7%, and 80.3% of cervical cancers, respectively, all of which were significantly related to advanced International Federation of Gynecology and Obstetrics stage, squamous cell histology, lymph node metastasis, and deep stromal invasion (P < 0.05). The altered expression pattern of EIF4A1 and EIF4E after preoperative brachytherapy was significantly correlated with the cervical cancer response to brachytherapy (P = 0.029 and 0.012, respectively). The decreased expression of EIF4A1 predicted better tumor-specific survival (P = 0.02). The alteration of EIF4A1 was an independent predictor for tumor-specific survival (P = 0.047; hazards ratio, 0.272; 95% confidence interval, 0.076-0.982).


CONCLUSIONS
Overexpression of EIF4A1, EIF4E, and EIF4G1 were acquired malignant phenotypic features of cervical cancer. EIF4A1 might function as a novel prognostic indicator and a potential therapeutic target for cervical cancer.
From the Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center; and Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
Shanhui
S
Liang
Yuqi
Y
Zhou
Yiran
Y
Chen
Guihao
G
Ke
Hao
H
Wen
Xiaohua
X
Wu
D014408:Biomarkers, Tumor / Q000378:metabolism*; D001918:Brachytherapy / Q000401:mortality*; D002294:Carcinoma, Squamous Cell / Q000378:metabolism / Q000401:mortality* / Q000532:radiotherapy / Q000556:secondary; D039601:Eukaryotic Initiation Factor-4A / Q000378:metabolism*; D039561:Eukaryotic Initiation Factor-4E / Q000378:metabolism; D039603:Eukaryotic Initiation Factor-4G / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007124:Immunoenzyme Techniques; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D011300:Preoperative Care; D011379:Prognosis; D017154:Stromal Cells / Q000378:metabolism / Q000473:pathology; D015996:Survival Rate; D046888:Tissue Array Analysis; D002583:Uterine Cervical Neoplasms / Q000378:metabolism / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy
D014408:Biomarkers, Tumor; C113920:EIF4G1 protein, human; D039561:Eukaryotic Initiation Factor-4E; D039603:Eukaryotic Initiation Factor-4G; D039601:Eukaryotic Initiation Factor-4A