Expression of REV7 has prognostic significance in cervical cancer treated with intensity-modulated radiation therapy.

Abstract

Background: Human cervical cancer is the fourth most common malignancies among females worldwide. Radiotherapy is crucial in the treatment of cervical cancer. REV7 is associated with the radiosensitivity of cancer cells. We aimed to investigate the relationship between the REV7 expression and the clinical outcome for patients with cervical cancer who received radiation therapy and identify new markers for studying radiosensitivity in cervical cancer.

Material and methods: The expression of REV7 in 71 cases of cervical squamous cell carcinoma (CSCC) tissues, 20 paracancerous tissues and 20 normal cervical epithelia tissues were analyzed by qRT-PCR and immunohistochemistry (IHC). Among them, 60 patients who underwent intensity-modulated radiation therapy (IMRT) and met the inclusion and exclusion criteria were divided into groups based on the REV7 IHC score: high-expression and low-expression. The relationship between REV7 expression level and short-term efficacy, recurrence and metastasis was investigated. Meanwhile, univariate, multivariate, and Kaplan-Meier analyses were used to analyze the association of REV7 expression with disease-free survival (DFS) and overall survival (OS).

Results: The expression of REV7 is upregulated in CSCC tissues. There was a higher likelihood of progression (pelvic recurrence or distant metastasis) in the group with high REV7 expression (P = 0.024). Moreover, the REV7-high expression patients showed a shorter DFS than the REV7-low expression group (P = 0.011).

Conclusions: The higher expression level of REV7 indicates an unfavorable prognosis in cervical cancer patients undergoing IMRT treatment. REV7 could potentially serve as a novel biomarker and therapeutic target for investigating the radiosensitivity of cervical cancer.