Expression and signi ! cance of FOXM 1 in human cervical cancer : A tissue microarray study

Objective: !is study was designed to investigate the expression and signi"cance of the Forkhead Box M1 (FOXM1) transcription factor in human cervical cancer. Methods: !e expression of FOXM1 protein was assessed in tissue microarrays containing 102 cervical cancer tissues by the Streptavidin–Peroxidase (SP) immunohistochemitry technique. !e relationship between FOXM1 protein and clinico-pathological features (pathological stages, pathological types, TNM stage) was analyzed. Results: FOXM1 protein was located in the cytoplasma and/or nucleus. !e overall expression of FOXM1 in the cytoplasm and nucleus was not associated with T stages (P=0.217) or lymph node status (P=0.313). !e nuclear expression of FOXM1 protein was not associated with T stage (P=0.508) or lymph node status (P=0.345). Elevated translocation and activity of FOXM1 were discovered with a secondary analysis that showed that the di#erences of the nuclear expression of FOXM1, among di#erent pathological stages, were statistically signi"cant (P<0.05). !e nuclear expression of FOXM1 in low di#erential cervical cancer tissues was signi"cantly higher than in high di#erential cervical cancer tissues (P<0.05). Conclusion: !e overexpression of FOXM1 protein in cervical cancer maybe associated with the progression of cervical cancer, and could be a potentially novel tumor marker useful for diagnosis and therapy of cervical cancer. ORIGINAL RESEARCH © 2011 CIM Clin Inv E1 Correspondence to: Dr. Hong Chen, Department of Gynecology and Obstetrics, Zhongnan Hospital of Wuhan University No. 169 Donghu Road, Wuhan, 430071, China E-mail: chen.hong888@126.com Clin Invest Med 2011; 34 (1): E1-E7. Although the 5-year relative survival rate of cervical cancer has improved, as a potentially preventable disease, cervical cancer is still the seventh in frequency overall and the second most common cancer among women worldwide [1, 2]. It has been evidenced that human papillomavirus (HPV) is one of the most important risk factors and maybe the most essential etiological agent in cervical cancer [3]. Recent studies have demonstrated that HPV alone is insu$cient in cervical cancer development. !e average of women with invasive cervical cancer is approximately 50 years of age, whereas the mean age of women with detectable HPV is much earlier than 28 years, which suggests in most cases a long precancerous state exist that allows the accumulation of secondary genetic changes [4, 5]. !erefore, there are must be other factors involving in the development of cellular genetic changes or in the activation of signal transduction pathways in the progress of carcinogenesis and tumor progression. Cancer is o%en de"ned as a disease of cell proliferation, and the majority of cancer studies have focused on examining functional consequences of activating and/or inactivating mutations in critical genes and signaling pathways regulating cell proliferation and/or cell death [6]. Forkhead box (FOX) is such a critical gene and FOX protein family is a growing group of transcription factors that plays important roles in cellular proliferation, di#erentiation and organ morphogenesis [7]. FOXM1, an essential member of FOX family, is broadly expressed in actively dividing cells and is crucial for cell cycledependent gene expression in the process of the cell cycle. As more and more studies have uncovered the mechanism by which FOXM1 controls the transcriptional network of genes that are essential for cell division and exit from mitosis, it has been proposed that FOXM1 may also mediate cellular transformation into cancer cells [8, 9]; however, little is known about FOXM1 expression in human cervical cancer and its clinical implications. In the present study, the expression and signi"cance of FOXM1 protein were examined by immunohistochemistry in a tissue micro-array composed of human cervical cancer tissues.