Expression and clinical implications of enhancer of Zeste homolog 2 and p53 protein in squamous cell carcinoma and precancerous lesions in the cervix

Abstract

ABSTRACT. We investigated the expression and clinical implications of enhancer of Zeste homolog 2 (EZH2) and p53 protein in cervical squamous cell carcinoma (SCC) and precancerous lesions. EZH2 and p53 expressions in SCC (168), cervical intraepithelial neoplasia (CIN)-I (19), , and normal tissues (30) were detected by streptavidin-peroxidase-conjugation. The correlation between coexpression of EZH2 and p53 protein and the clinic pathological features and prognosis of SCC were discussed. The positive expression rates of EZH2 and p53 were 6.7, 37.0, and 75.6%, and 3.3, 21.1, and 39.3% in normal cervical tissues, CIN, and SCC, respectively, which were significantly different (P < 0.05). The positive expression rate of EZH2 and p53 protein in SCC patients with and without lymph node metastasis was 82.9 and 70.4% (EZH2) and 45.7 and 34.7% (p53), respectively, which was also a significant difference (P < 0.05). The progression-free survival (PFS) rates in followed-up patients (N = 143) who were EZH2-and p53-negative, EZH2-or p53-positive, and EZH2- and p53-positive were 71.3 ± 1.9, 66.1 ± 2.0, and 51.3 ± 3.8 months, respectively, which was a significant difference (P < 0.001); the overall survival among these groups was 72.9 ± 1.1, 68.6 ± 1.8, and 57.4 ± 3.4 months, respectively (P < 0.001). Multivariate analyses revealed that EZH2 expression, lymph node metastasis, and tumor staging were independent prognostic factors of SCC. EZH2 and p53, which affect lymph node metastasis and prognosis of SCC, may play a key role in the occurrence and development of SCC.

Evaluation of Immunohistochemical Expression of Enhancer of Zeste Homolog 2 (EZH2) and Its Association With Clinicopathological Variables in Carcinoma Cervix

“…However, no significant correlation (p = 0.118) was obtained between tumor size and EZH2 immunoexpression (Table 2). This finding was similar to studies by Zhang et al, Jin et al, and Azizmohammadi et al who also documented insignificant association with p values of 0.849, 0.077, and 0.63 respectively [20,22,24].…”

“…In the present study, out of 60 cases of carcinoma cervix, high expression of EZH2 was present in 41 cases (68.3%) (Table 1). Similar to our study, Zhang et al investigated EZH2 expression in 168 cases of cervical SCC and found positive expression rate of 75.6% which was also statistically significant (p < 0.05) [20]. Liu et al also documented positive expression in 68.3% cases of cervical cancer [21].…”

“…In this study, among the various prognostically important clinicopathological variables that were analyzed with regard to EZH2 immunoexpression, it was observed that higher FIGO stage of carcinoma cervix showed high immunoexpression score of EZH2 with statistical significance (p = 0.031) (Table 2 ) which was in concordance with the study done by Zhang et al who studied 168 cases of cervical SCC of different FIGO stages and observed increasing EZH2 expression with ascending stages of SCC with statistical significance (p < 0.05) [ 20 ]. Similarly, in an another study, Chen et al studied 168 patients with cervical SCC and documented that the expression of EZH2 was upregulated with ascending stages of cervical cancer (p = 0.005) [ 8 ].…”

“…which was in concordance with the study done by Zhang et al who studied 168 cases of cervical SCC of different FIGO stages and observed increasing EZH2 expression with ascending stages of SCC with statistical significance (p < 0.05)[20]. Similarly, in an another study, Chen et al studied 168 patients with cervical SCC and documented that the expression of EZH2 was upregulated with ascending stages of cervical cancer (p = 0.005)[8].…”