Clinical significance of FOXM1 and Gli-1 protein expression in high-grade ovarian serous carcinoma

Abstract

Objective: To investigate the different expression and prognostic significance of forkhead box M1 (FOXM1) and Gli-l in ovarian high grade serous carcinoma (HGSC). Methods: The expressions of FOXM1 and Gli-1 in 94 cases of HGSC and 20 cases of normal fallopian tube tissues were detected by immunohistochemistry. Kaplan-Meier analysis and Cox multivariate survival analysis were used to assess the relationship of the FOXM1 and Gli-1 levels with age, International Federation of Gynecology and Obstetrics (FIGO) stage, omental metastasis, and residual foci and prognosis of HGSC. Results: The positive rates of FOXM1 and Gli-1 expression in HGSC were 79.8% (75/94) and 77.7% (73/94), respectively, both significantly higher than those of the normal controls (P<0.05). The expressions of FOXM1 and Gli-1 were significantly correlated with FIGO stage, and both of their positive rates in stage Ⅲ-Ⅳpatients were significantly higher than those in stage Ⅰ-Ⅱ cases (P<0.001). The expressions of FOXM1 in HGSC were positively correlated with Gli-1.Kaplan-Meier analysis revealed that the 5-year overall survival rates of FOXM1- and Gli-1-positive groups were 8.0% and 6.8%, significantly lower than 36.8% and 38.1% of the FOXM1- and Gli-1-negative groups, respectively (P<0.05 for both). Cox multivariate survival analysis revealed that FIGO stage and overexpression of FOXM1 protein were independent prognostic factors of HGSC patients (P<0.05 for both). Conclusions: The overexpression of FOXM1 and Gli-1 proteins participate in the carcinogenesis of HGSC, and are significantly associated with FIGO stage. The protein expression of FOXM1 is positively correlated with Gli-1 in HGSC. Expression of FOXM1 protein and FIGO stage are independent prognostic factors of HGSC.