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

Sakata,Jun; Kajiyama,Hiroaki; Suzuki,Shiro; Utsumi,Fumi; Niimi,Kaoru; Sekiya,Ryuichiro; Shibata,Kiyosumi; Senga,Takeshi; Kikkawa,Fumitaka

doi:10.3892/ol.2017.6658

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

Authors:
- Jun Sakata
- Hiroaki Kajiyama
- Shiro Suzuki
- Fumi Utsumi
- Kaoru Niimi
- Ryuichiro Sekiya
- Kiyosumi Shibata
- Takeshi Senga
- Fumitaka Kikkawa
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Affiliations: Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Nagoya 466‑8550, Japan, Division of Tumor Biology, Graduate School of Medicine, Nagoya University, Nagoya 466‑8550, Japan
Published online on: July 24, 2017 https://doi.org/10.3892/ol.2017.6658
Pages: 4287-4293

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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.

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