Department of Radiotherapy, King George's Medical University, Lucknow, India.
The Royal Marsden NHS Foundation Trust, Sutton, UK.
Asia Pac J Clin Oncol. 2024 Jun;20(3):407-415. doi: 10.1111/ajco.14049. Epub 2024 Feb 25.
Cancer stem cell biomarkers SRY (sex-determining region Y)-box 2 (SOX2) and octamer-binding transcription factor 4 (Oct4) account for radioresistance in cervical squamous cell cancers (CSCCs). Their clinical implications are limited and contradictory.
In this prospective cohort study, we recruited patients with FIGO IB2-IVA CSCC treated with primary chemoradiotherapy on regular follow-up. Tissue biopsy specimens were evaluated for SOX2 and Oct4 expression by immunohistochemistry, quantified by a product of proportion and intensity scores.
A total of 59 patients were included. Most had a moderately differentiated (81%), keratinizing (59%) CSCC, and ≥FIGO stage IIB disease (95%). SOX2 expression (high:low 21:38 patients) and Oct4 expression (high:low 4:55 patients) had a significant interrelation (p = 0.005, odds ratio (95% CI) - 1.23 (1.004-1.520)). At a median follow-up of 36 months, the 3-year overall survival (OS) was 60% and 53% for low and high SOX2 expression (p = 0.856), and 54% and 100% for low and high Oct4 expression (p = 0.114). The 3-year disease-frese survival (DFS) was 65% and 50% in the low and high SOX2 expression (p = 0.259), and 59% and 75% for low and high Oct4 expression (p = 0.598). SOX2 expression was the only variable significantly associated with a lower OS and DFS on regression analysis.
Our study demonstrated a trend toward improved OS and DFS with low SOX2 and high Oct4 expression in CSCC patients undergoing chemoradiotherapy.
癌症干细胞标志物性别决定区 Y 盒 2（SOX2）和八聚体结合转录因子 4（Oct4）导致宫颈鳞状细胞癌（CSCC）的放射抵抗。它们的临床意义有限且相互矛盾。
在这项前瞻性队列研究中，我们招募了在常规随访中接受原发放化疗治疗的 FIGO IB2-IVA 期 CSCC 患者。通过免疫组织化学评估 SOX2 和 Oct4 的表达，并通过比例和强度评分的乘积进行量化。
共纳入 59 例患者。大多数为中分化（81%）、角化（59%）CSCC，且≥FIGO 分期 IIB 期疾病（95%）。SOX2 表达（高：低 21:38 例）和 Oct4 表达（高：低 4:55 例）之间存在显著的相互关系（p=0.005，优势比（95%可信区间）-1.23（1.004-1.520））。中位随访 36 个月时，低和高 SOX2 表达患者的 3 年总生存率（OS）分别为 60%和 53%（p=0.856），低和高 Oct4 表达患者的 3 年无病生存率（DFS）分别为 54%和 100%（p=0.114）。低和高 SOX2 表达患者的 3 年疾病无复发生存率（DFS）分别为 65%和 50%（p=0.259），低和高 Oct4 表达患者的 3 年疾病无复发生存率分别为 59%和 75%（p=0.598）。回归分析显示，SOX2 表达是唯一与 OS 和 DFS 降低显著相关的变量。
我们的研究表明，在接受放化疗的 CSCC 患者中，SOX2 低表达和 Oct4 高表达与 OS 和 DFS 改善趋势相关。
