宫颈癌患者接受放化疗后，癌症干细胞标志物 SOX2 和 Oct4。

Cancer stem cell biomarkers SOX2 and Oct4 in cervical cancer patients undergoing chemoradiotherapy.

机构信息

Department of Radiotherapy, King George's Medical University, Lucknow, India.

The Royal Marsden NHS Foundation Trust, Sutton, UK.

出版信息

Asia Pac J Clin Oncol. 2024 Jun;20(3):407-415. doi: 10.1111/ajco.14049. Epub 2024 Feb 25.

DOI:10.1111/ajco.14049

PMID:38403883

Abstract

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSION

Our study demonstrated a trend toward improved OS and DFS with low SOX2 and high Oct4 expression in CSCC patients undergoing chemoradiotherapy.

摘要

背景

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。

方法

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。

结果

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。