Chen Ainian, Zhong Lingling, Lv Jia
Department of Neurology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu 223300, P.R. China.
Department of Neurosurgery, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu 223300, P.R. China.
Oncol Lett. 2019 Jul;18(1):751-757. doi: 10.3892/ol.2019.10351. Epub 2019 May 13.
Gliomas are the most common primary tumors in adult central nervous system and result in disappointing survival outcomes. FOXL1, as a transcription factor, plays an important role in regulating the expression of genes involved in cell metabolism, proliferation and differentiation. In this study, we investigated the relationship between FOXL1 expression and prognosis of patients with glioma. We selected 611 glioma patients from The Cancer Genome Atlas (TCGA) database and 132 glioma patients from Huai'an First People's Hospital (PFHH). The prognostic values of FOXL1 in glioma were analyzed in both cohorts. In TCGA cohort, the median (10.2389) was used as the cut-off value of FOXL1 mRNA levels in tumor tissue. Kaplan-Meier analysis showed that higher WHO glioma grade (P<0.001) and expression of FOXL1 (P<0.001) were associated with worse overall survival (OS). The univariate Cox regression model revealed that age (P<0.001), WHO grade (P<0.001), histological type (P<0.001) and FOXL1 expression (P<0.001) were associated with prognosis of glioma patients. In PFHH cohort, expression of FOXL1 in tumor cells was detected by immunohistochemistry (IHC) staining based on a tissue microarray (TMA) sample. Kaplan-Meier analysis also showed that WHO glioma grade (P<0.001) and expression of FOXL1 (P=0.012) were associated with OS in glioma patients. The univariate Cox regression showed that WHO grade (P=0.001), histological type (P<0.001) and FOXL1 expression (P=0.013) were associated with prognosis of glioma patients. In both cohorts Kaplan-Meier subgroup analyses showed FOXL expression correlated with OS in high WHO grade subgroup, while low grade subgroup showed no such correlation. This study showed that higher expression of FOXL1 is associated with poor OS of glioma patients in TCGA and PFHH cohorts. Especially, FOXL1 overexpression is associated with worse outcomes in high WHO grade subgroup. Our findings suggest that FOXL1 expression is a candidate predictor of clinical outcome in glioma patients and may act as an effective molecular marker for immunotherapeutic strategies of glioma patients in clinical practice.
胶质瘤是成人中枢神经系统中最常见的原发性肿瘤，其生存结果令人失望。FOXL1作为一种转录因子，在调节参与细胞代谢、增殖和分化的基因表达中发挥重要作用。在本研究中，我们调查了FOXL1表达与胶质瘤患者预后之间的关系。我们从癌症基因组图谱（TCGA）数据库中选取了611例胶质瘤患者，并从淮安市第一人民医院（PFHH）选取了132例胶质瘤患者。在两个队列中分析了FOXL1在胶质瘤中的预后价值。在TCGA队列中，将中位数（10.2389）用作肿瘤组织中FOXL1 mRNA水平的截断值。Kaplan-Meier分析表明，较高的世界卫生组织（WHO）胶质瘤分级（P<0.001）和FOXL1表达（P<0.001）与较差的总生存期（OS）相关。单变量Cox回归模型显示，年龄（P<0.001）、WHO分级（P<0.001）、组织学类型（P<0.001）和FOXL1表达（P<0.0）与胶质瘤患者的预后相关。在PFHH队列中，基于组织微阵列（TMA）样本通过免疫组织化学（IHC）染色检测肿瘤细胞中FOXL1的表达。Kaplan-Meier分析还表明，WHO胶质瘤分级（P<0.001）和FOXL1表达（P=0.012）与胶质瘤患者的OS相关。单变量Cox回归显示，WHO分级（P=0.001）、组织学类型（P<0.001）和FOXL1表达（P=0.013）与胶质瘤患者的预后相关。在两个队列中，Kaplan-Meier亚组分析表明，在WHO高分级亚组中FOXL表达与OS相关，而低分级亚组则无此相关性。本研究表明，在TCGA和PFHH队列中，较高的FOXL1表达与胶质瘤患者较差的OS相关。特别是，FOXL1过表达与WHO高分级亚组中较差的结果相关。我们的研究结果表明，FOXL1表达是胶质瘤患者临床结局的候选预测指标，在临床实践中可能作为胶质瘤患者免疫治疗策略的有效分子标志物。
