E2F1/2/7/8 as independent indicators of survival in patients with cervical squamous cell carcinoma
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Cancer Cell International Open Access
PRIMARY RESEARCH
E2F1/2/7/8 as independent indicators of survival in patients with cervical squamous cell carcinoma Chang Yang†, Zhao‑Cong Zhang†, Tian ‑Bo Liu, Ye Xu, Bai‑Rong Xia and Ge Lou*
Abstract Background: Cervical cancer is the second leading cause of death in women 20–39 years old. Because coverage for cervical cancer screening is low, and the vaccination rate of human papillomavirus (HPV) is poor in some coun‑ tries, potential markers to detect the disease at early stages are needed. E2F transcription factors (E2Fs) are a family of transcription factors that function in cell proliferation, differentiation, apoptosis, and tumorigenesis. As abnormal activation and regulation of E2Fs are related to tumor development and poor prognosis, we performed bioinformatic analyses and in vitro assays to evaluate the role of E2Fs in cervical cancer. Methods: Transcriptional expression of E2Fs was initially evaluated in silico using ONCOMINE and Gene Expression Profiling Interactive Analysis (GEPIA), followed by evaluation of E2F1/2/7/8 protein levels using immunohistochemis‑ try in 88 patient tissues. E2F2 and E2F7 mRNA levels were measured by RT-qPCR. LinkedOmics and Metascape were used to predict functions of E2Fs, and in vitro experiments were performed to assess the tumorigenic role of E2F2 and E2F7. Results: In silico analysis showed that E2F1/2/7/8 were significantly overexpressed in cervical cancer, findings which were confirmed at the protein level using immunohistochemistry. Further, upregulation of E2F1/2/7/8 was associated with different clinicopathological prognostic factors, including positivity for lymph vessel invasion and deep invasion of cervical stroma. Increased expression of E2F1/2/7/8 was also related to shorter overall survival (OS) and disease-free survival (DFS) in patients with cervical cancer. Using multivariate analysis, we confirmed E2F1/2/7/8 as independent prognostic factors for shorter OS of patients with cervical cancer. Finally, in vitro experiments showed that E2F2 and E2F7 are involved in cell proliferation and migration and cell cycle regulation in both HPV-positive and HPV-negative cervical cancer cells. Conclusions: E2F1/2/7/8 may be prognostic biomarkers for survival of patients with cervical cancer. E2F2 and E2F7 are involved in cell proliferation, migration, and cell cycle in both HPV-positive and HPV-negative cervical cancer cells. Keywords: E2F transcription factors, Cervical cancer, Prognostic value, Bioinformatic analysis
*Correspondence: [email protected] † Chang Yang and Zhao-Cong Zhang contributed equally to this work Department of Gynecology Oncology, Harbin Medical University Cancer Hospital, Harbin 150086, P.R. China
Background According to the American Cancer Society, it is estimated that 13,800 cases of invasive cervical cancer will be diagnosed and 4,290 deaths from cervical cancer will occur in the United States in 2020 [1]. It is the second leading cause of death in 20- to 39-year-old women, responsible for 10 pr
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