Impact of positive ZEB1 expression in patients with epithelial ovarian carcinoma as an oncologic outcome-predicting indicator

Abstract

Abstract. Several previous studies have revealed that the expression of zinc finger E-box binding homeobox 1 (ZEB1) in solid malignancies has an important significance on the clinical outcome of patients. However, the association between ZEB1 expression and survival in patients with epithelial ovarian carcinoma (EOC) remains unclear. The objective of the present study was to examine the extent of ZEB1 expression in EOC using immunohistochemical staining and investigate its association with patient outcome. A total of 40 patients with EOC initially treated with cytoreductive surgery and systematic chemotherapy were enrolled. ZEB1 expression was immunohistochemically categorized as negative, weak, moderate and strong according to the size of the staining area, and intensity. Subsequently, the associations between ZEB1 expression and recurrence/progression-free survival (RFS) rate were examined. The median age of patients in the current study was 54 years old (range, 22-72 years old). Among these patients, 15 (37.5%) exhibited International Federation of Gynecology and Obstetrics stage I disease, and 10 (25.0%), 13 (32.5%), and 2 (5%) had stage II, III, and IV disease, respectively. No patients with negative expression of ZEB1 experienced recurrence. In addition, ZEB1 expression was identified to be a significant predictor of a poorer RFS rate compared with negative expression (negative vs. weak, moderate and strong, P= 0.0126). Furthermore, multivariate analyses revealed that moderate and strong ZEB1 expression levels were significant prognostic indicators of a poorer RFS rate in patients with EOC (hazard ratio, 2.265; 95% confidence interval, 1.072-8.021; P=0.0349). Confining analysis to patients with the clear-cell/mucinous histological type, those with moderate/strong ZEB1 expression demonstrated a significantly poorer RFS rate (P=0.0025). Positive ZEB1 expression may be an indicator to predict unfavorable RFS in patients with EOC.

The transcription factor ZEB1 mediates the progression of epithelial ovarian cancer by promoting the transcription of CircANKRD17

“…Clinically, the high expression of ZEB1 was strongly correlated with tumor metastasis, advanced cancer, and the survival rate. The above results were consistent with the findings of Suzuki et al [ 25 ] More importantly, knockdown of ZEB1 significantly inhibited N‐cadherin and vimentin but promoted E‐cadherin expression in EOC cells, which means that the EMT process was significantly inhibited by transfection with si‐ZEB1. The proliferation, invasion, and migration of EOC cells were also significantly reduced after si‐ZEB1 transfection.…”

KIF20A expression as a prognostic indicator and its possible involvement in the proliferation of ovarian clear‑cell carcinoma cells

“…The two investigators were in agreement on all the slides examined. Based on the immunostaining activity, a semi-quantitative score was assigned according to the intensity and area of the stained cells, as previously described ( 30 ). For the evaluation of KIF20A expression, the staining intensity was scored as 0 (negative-weak), 1 (medium), 2 (strong), or 3 (very strong).…”

Exploring the tumor micro-environment in primary and metastatic tumors of different ovarian cancer histotypes

“…The expression of TP53 exhibited low prevalence across all histotypes ( Figure 3C ; Supplementary Figure S3C ). The expression levels of additional markers ( Sakata et al, 2017 ; Peres et al, 2018 ; Leskela et al, 2019 ) VIM and ARID1A were used to distinguish other histotypes. The EMT repressors, zinc finger E-Box binding homeobox 1 and 2, ( ZEB2, ZEB1 ) ( Sakata et al, 2017 ; Leskela et al, 2019 ) related to endometrial carcinosarcoma, a mix of (epithelial) carcinoma, and (mesenchymal) sarcoma, were used to distinguish endometrioid and MMMT histotypes.…”