Tian Yuejun, Qi Ping, Niu Qian, Hu Xuemei
Department of Obstetrics and Gynecology, Lanzhou University Second Hospital, Lanzhou, China.
Department of Clinical Laboratory, Lanzhou University Second Hospital, Lanzhou, China.
Front Mol Biosci. 2020 Feb 28;7:22. doi: 10.3389/fmolb.2020.00022. eCollection 2020.
Activation of Snail and synergistic loss of E-cadherin are hallmark features of the epithelial-mesenchymal transition (EMT), which contributes to the metastasis phenotype of epithelial cancer cells. However, the prognostic impact of Snail and of its combination with E-cadherin and with other EMT prognostic markers has not yet been systematically studied in cervical carcinoma. This study aimed to explore the prognostic value of combined Snail and E-cadherin in patients with cervical carcinoma and compared it to the prognostic value of other EMT prognostic markers.
We retrospectively identified every initial diagnosis of cervical carcinoma among 203 patients treated at our hospital in China from January 2008 to March 2013. We examined the prognostic significance of Snail and other EMT protein markers, such as E-cadherin, Slug, ZEB1, Twist, Vimentin, and Survivin, by univariate and multivariate survival analyses.
Multivariate analyses showed that Snail and E-cadherin were significant biomarkers for overall survival (OS) in cervical carcinoma patients (HR, hazard ratio = 1.744, = 0.036 and HR = 1.738, = 0.047; respectively). Moreover, a combined index including Snail and E-cadherin showed enhanced prognostic value compared to that of Snail or E-cadherin alone. The present data demonstrate that Snail shows a negative correlation with E-cadherin ( < 0.001). High Snail expression and low E-cadherin expression were also more common in high tumor stages ( = 0.044 and = 0.036; respectively), and lymph node metastasis (both < 0.001). Moreover, Snail was a superior prognosis factor compared to Slug, ZEB1, Twist, Vimentin, and Survivin in cervical carcinoma.
Based on our results, Snail and E-cadherin may be considered as independent prognosis markers, and the combination of Snail and E-cadherin might improve the OS prediction accuracy for patients with cervical carcinoma.
Snail的激活以及E-钙黏蛋白的协同缺失是上皮-间质转化（EMT）的标志性特征，EMT促成上皮癌细胞的转移表型。然而，Snail及其与E-钙黏蛋白以及其他EMT预后标志物联合的预后影响在宫颈癌中尚未得到系统研究。本研究旨在探讨Snail与E-钙黏蛋白联合对宫颈癌患者的预后价值，并将其与其他EMT预后标志物的预后价值进行比较。
我们回顾性确定了2008年1月至2013年3月在中国我院接受治疗的203例患者中每例宫颈癌的初始诊断。我们通过单因素和多因素生存分析研究了Snail和其他EMT蛋白标志物，如E-钙黏蛋白、Slug、ZEB1、Twist、波形蛋白和生存素的预后意义。
多因素分析显示，Snail和E-钙黏蛋白是宫颈癌患者总生存（OS）的重要生物标志物（风险比HR分别为1.744，P = 0.036和HR = 1.738，P = 0.047）。此外，与单独的Snail或E-钙黏蛋白相比，包含Snail和E-钙黏蛋白的联合指标显示出更高的预后价值。目前的数据表明Snail与E-钙黏蛋白呈负相关（P < 0.001）。高Snail表达和低E-钙黏蛋白表达在高肿瘤分期（分别为P = 0.044和P = 0.036）以及淋巴结转移中也更常见（两者P均< 0.001）。此外，在宫颈癌中，Snail是比Slug、ZEB1、Twist、波形蛋白和生存素更好的预后因素。
基于我们的结果，Snail和E-钙黏蛋白可被视为独立的预后标志物，Snail与E-钙黏蛋白的联合可能提高宫颈癌患者OS预测的准确性。
