Expression In Cervical Cancer Research Articles

The efficacy of immune checkpoint inhibitors on low PD-L1 cervical cancer: A meta-analysis.

The effectiveness of immune checkpoint inhibitors (ICIs) in low programmed death ligand 1 (PD-L1) expression in cervical cancer (CC) patients remains unknown. We aimed to evaluate the efficacy of ICIs in low PD-L1 expression CCpatients. The study is an individual patient data (IPD)-based meta-analysis. IPD were compiled through KMSubtraction and IPDfromKM methodologies from high-quality randomized clinical trials and single-arm studies which reported overall survival (OS) or progression-free survival (PFS) stratified by PD-L1 expression. Kaplan-Meier curves and Cox regression analysis were employed to evaluate the survival benefits of ICIs. A total of eightstudies and 1110 cases were included in the analysis. Within the low PD-L1 expression subgroup, ICI combination therapy, but not ICI monotherapy, demonstrated significant OS benefits over non-ICI treatment (hazard ratio [HR] = 0.61, 95% confidence interval [CI]:0.36-1.04, p = 0.06). Concerning PFS, ICI monotherapy was associated with a negative effect compared to non-ICI treatment (HR = 4.59, 95% CI:2.32-9.07, p < 0.001). Notably, both OS and PFS outcomes were unfavorable for ICI monotherapy compared to both non-ICI and ICI combination therapy in the combined positive score <1 subgroup (OS: HR = 2.60, 95% CI:1.31-5.16, p = 0.008; PFS: HR = 7.59, 95% CI:3.53-16.31, p < 0.001). In patients with CCand low PD-L1 expression, ICI monotherapy may not be considered as the optimal treatment strategy when compared to non-ICI treatment or ICI combination therapy. CRD42023395103.

Association between programmed cell death ligand-1 expression in patients with cervical cancer and apparent diffusion coefficient values: a promising tool for patient´s immunotherapy selection.

To investigate the associations between apparent diffusion coefficient (ADC) values extracted from three different region of interest (ROI) position approaches and programmed cell death ligand-1 (PD-L1) expression, and evaluate the performance of the nomogram established based on ADC values and clinicopathological parameters in predicting PD-L1 expression in cervical cancer (CC) patients. Through retrospective recruitment, a training cohort of 683 CC patients was created, and a validation cohort of 332 CC patients was prospectively recruited. ROIs were delineated using three different methods to measure the mean ADC (ADCmean), single-section ADC (ADCss), and the minimum ADC of tumors (ADCmin). Logistic regression was employed to identify independent factors related to PD-L1 expression. A nomogram was drawn based on ADC values combined with clinicopathological features, its discrimination and calibration performances were estimated using the area under the curve (AUC) of receiver operating characteristic and calibration curve. The clinical benefits were evaluated by decision curve analysis. The ADCmin independently correlated with PD-L1 expression. The nomogram constructed with ADCmin and other independent clinicopathological-related factors: FIGO staging, pathological grade, parametrial invasion, and lymph node status demonstrated excellent diagnostic performance (AUC = 0.912 and 0.903, respectively), good calibration capacities, and greater net benefits compared to the clinicopathological model in both the training and validation cohorts. ADCmin independently correlated PD-L1 expression, and the nomogram established with ADCmin and clinicopathological independent prognostic factors had a strong predictive performance for PD-L1 expression, thereby serving as a promising tool for selecting cases eligible for immunotherapy. The minimum ADC can serve as a reliable imaging biomarker related to PD-L1 expression; the established nomogram combines the minimum ADC and clinicopathological factors that can assist clinical immunotherapy decisions.

Abstract 2955: HPV E6* and senescence-related gene expression in cervical cancer

Abstract Previous work in our lab found that increased expression of the E6* variant of the HPV E6 viral protein was significantly correlated with worse response to standard-of-care chemoradiation (CRT) and progression-free survival, independently of HPV genotype. In vitro validation showed that overexpression of E6* induces senescence in an HPV 16-positive cervical cancer cell line. Given these findings, we hypothesized that increased E6* expression mediates resistance to CRT by inducing a reversible state of tumor cell senescence. We created a senescence score using ten genes that have been consistently reported in the literature as associated with senescence. Using an institutional cohort of 68 patients with cervical cancer with prospectively collected clinical outcome data, we performed bulk RNA sequencing to assess senescence scores before CRT and determine whether there is an association between senescence scores and E6* expression. Using a second institutional cohort of 35 patients with cervical cancer treated with CRT with pre and posttreatment tumor biopsies, we performed bulk RNA sequencing to evaluate the same relationship and determine whether expression of senescence-related genes was affected by CRT. Nine cervical cancer cell lines stratified into low- and high-E6* expression groups will be assessed regarding their senescence score, beta-galactosidase staining, and SASP expression before and after CRT. In our first cohort, there was no correlation between E6*:E6 expression ratio and senescence score, regardless of HPV genotype. In our second cohort, CRT increased senescence score in CRT-treated samples (p &amp;lt; 0.01), but p16INK4a expression significantly decreased compared to pre-treatment samples (p &amp;lt; 0.01). Increased senescence score was not associated with cancer recurrence. There was no significant difference in senescence scores between different HPV genotypes before therapy. Tumors that were positive for HPV 16 or HPV 18 had significantly lower senescence scores compared to HPV negative tumors (p = 0.037 and p = 0.038, respectively) after CRT. Among HPV 16-positive tumors (n = 12), there was no correlation between E6*:E6 expression ratio and senescence score before or after CRT. We found no association between senescence score and E6* expression, and between senescence score and cancer recurrence after CRT in our dataset. Additionally, our results suggest that p16INK4a might not be an appropriate senescence marker in tumors that have intrinsically high p16INK4a expression, such as in cervical cancer, reinforcing the need for a cervical cancer-specific senescence signature. We are currently testing beta-galactosidase and SASP expression in vitro and in vivo before and after CRT. Citation Format: Louise Medina Bengtsson, Matthew Inkman, Naoshad Muhammad, Leahan Castillo, Naomi Msengi, Tyler McKinnish, Nishanth Gabriel, Jin Zhang, Julie Schwarz. HPV E6* and senescence-related gene expression in cervical cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2955.

NUPR1 contributes to activate TFE3-dependent autophagy leading to cervical cancer proliferation

Cervical cancer is a malignant tumor that occurs in the cervix of women and endangers their lives. In this study, we aimed to assess the roles of NUPR1 and TFE3 in cervical cancer. The Cancer Genome Atlas (TCGA) database was used to assess the correlation between NUPR1 and TFE3 expression in cervical cancer. By silencing NUPR1 and TFE3, and through 3-MA treatment, we determined whether their silencing could lead to lysosomal dysfunction, thereby inhibiting autophagy and cervical cancer cell proliferation. Their roles were further analyzed using molecular biological methods. Silencing NUPR1 and TFE3 inhibited cell proliferation and decreased the expression levels of autophagy-related genes, p62 and LC3B. By tracing lysosomes within cells, NUPR1 and TFE3 knockdown were found to induce lysosomal dysfunction, thereby inhibiting autophagy. In vivo experimental studies have shown that knockdown of NUPR1 and TFE3 can inhibit tumor growth, while reducing the ki67, p62, and LC3B expression levels and promoting apoptosis. Furthermore, the expression levels of lamp1 and lamp2, and the phosphorylation of PI3K (p-PI3K) and Akt (p-Akt) were significantly reduced after NUPR1 and TFE3 knockdown. However, treatment with 3-MA and overexpression of TFE3 could partially reverse the effect of silencing NUPR1. Overall, silencing NUPR1 reduced autophagy by inhibiting TFE3 in cervical cancer. Our results supply new evidence for the use of NUPR1 as a therapeutic target in cervical cancer.

A paradigm for post-embryonic Oct4 re-expression: E7-induced hydroxymethylation regulates Oct4 expression in cervical cancer.

The Octamer-binding transcription factor-4 (Oct4) is upregulated in different malignancies, yet a paradigm for mechanisms of Oct4 post-embryonic re-expression is inadequately understood. In cervical cancer, Oct4 expression is higher in human papillomavirus(HPV)-related than HPV-unrelated cervical cancers and this upregulation correlates with the expression of the E7 oncogene. We have reported that E7 affects the Oct4-transcriptional output and Oct4-related phenotypes in cervical cancer, however, the underlying mechanism remains elusive. Here, we characterize the Oct4-protein interactions in cervical cancer cells via computational analyses and Mass Spectrometry and reveal that Methyl-binding proteins (MBD2 and MBD3), are determinants of Oct4-driven transcription. E7 triggers MBD2 downregulation and TET1 upregulation, thereby disrupting the methylation status of the Oct4 gene. This coincides with an increase in the total DNA hydroxymethylation leading to the re-expression of Oct4 in cervical cancer and likely affecting broader transcriptional patterns. Our findings reveal a previously unreported mechanism by which the E7 oncogene can regulate Oct4 re-expression and global transcriptional patterns by increasing DNA hydroxymethylation and lowering the barrier to cellular plasticity during carcinogenesis.

Lymphoid-specific helicase inhibits cervical cancer cells ferroptosis by promoting Nrf2 expression.

Cervical cancer is a major cause of morbidity and mortality in women worldwide. The underlying mechanisms of its progression are not well understood. In this study, we investigated the role of lymphoid-specific helicase (HELLS) in cervical cancer. We measured HELLS expression in cervical cancer and assessed its function using gain- and loss-of-function experiments. Cell viability was measured using the Cell Counting Kit-8 (CCK8 ) assay, and cell proliferation was analyzed using colony formation and EdU assays. We found that HELLS was significantly increased in cervical cancer and that its overexpression promoted cell viability (P < 0.01) and colony formation (P < 0.001). In contrast, si-HELLS suppressed these effects. Moreover, HELLS overexpression inhibited cell death induced by the ferroptosis inducer erastin (P < 0.01). Mechanistically, we found that HELLS promoted cervical cancer proliferation by regulating nuclear factor erythroid 2-related factor 2 (Nrf2)-mediated ferroptosis. Our data suggest that HELLS promotes cervical cancer proliferation by inhibiting Nrf2 expression. Therefore, HELLS knockdown may be an effective treatment for cervical cancer.

Hsa_Circ_0000021 Sponges miR-3940-3p/KPNA2 Expression to Promote Cervical Cancer Progression.

Circular RNAs (circRNAs) have a vital role in the occurrence of numerous cancers. However, its function and pattern of expression in cervical cancer (CC) remain unclear. This research aims to investigate the hsa_circ_000002's regulatory mechanism in CC. Hsa_circ_0000021, miR-3940-3p, and KPNA2 expression levels were estimated through qRT-PCR. Nuclear/cytoplasmic separation was conducted to find the subcellular location of hsa_circ_0000021. Western blot was done to estimate the levels of KPNA2 protein. CCK-8, BrdU, wound healing, transwell, and tumor xenograft assays were performed to study how hsa_circ_0000021/miR-3940-3P/KPNA2 function affect CC. Hsa_circ_0000021's targeting relationships with miR-3940-3p and KPNA2 were ascertained through RIP and luciferase experiments. Hsa_circ_0000021 and KPNA2 were overexpressed and inversely associated with the levels of miR-3940-3p in CC. Knocking down either hsa_circ_0000021 or KPNA2 repressed the growth of CC tumors as well as the proliferation, invasion, and migration of CC cells. Silencing miR-3940-3p promoted the malignant proliferation of CC cells. Regarding its mechanism, hsa_circ_0000021 affected the malignant CC cell proliferation via the sponging of miR-3940-3p, which targeted KPNA2. Hsa_circ_0000021 regulates the miR-3940-3p/KPNA2 axis to promote CC occurrence. This potentially is a novel target for CC treatment.

Association between Human Papilloma Virus (HPV) genotype and protein of retinoblastoma expression in cervical cancer

Link of Video Abstract: https://youtu.be/5Q9QmV4Qmyg Background: Regarding prevalence among females worldwide, cervical cancer ranks fourth and has a high fatality rate. Cervical cancer growth is correlated with high-risk human papillomavirus (HPV) infection. Retinoblastoma protein (pRb) is a protein that interacts with E6/E7 oncoproteins to regulate cell proliferation, differentiation, and death. Mutations on the E6/E7 protein oncogenes of high-risk HPV can disrupt this relationship. This investigation aims to establish the association between pRb expression and the HPV genotype. Methods: This observational cross-sectional study examined 43 patients diagnosed with cervical cancer at Wahidin Sudirohusodo Hospital and its network. Samples were taken using consecutive random sampling based on established criteria. HPV genotype was examined using the polymerase chain reaction (PCR) method, while pRB expression was assessed by immunohistochemical examination. The relationship between the two variables was assessed using the Chi-Square test. Results: There were 5 (11.6%) patients with HPV type 16, 14 (32.6%) with HPV type 18, 12 (27.9%) with other types of HPV and 12 (27.9%) were negative for HPV. Examination of pRb expression showed that 33 (76.7%) samples had +2 expression, 7 (16.3%) had +1 expression, and 3 (7.0%) samples had no pRb expression. The pRb expression and HPV type were not significantly correlated in this study (p = 0.410). However, pRb expression and cervical cancer clinical stage were shown to be significantly correlated (p = 0.007). Conclusion: pRb expression is more prevalent when a malignancy is more advanced. In this investigation, no association between HPV genotype and pRb expression was discovered, despite oncogene mutations being involved in the regulation mechanism of cell proliferation, differentiation, and apoptosis.

Association between Human Papilloma Virus (HPV) genotype and mutant protein 53 (p53) expression in cervical cancer

Link of Video Abstract:https://youtu.be/fff-Unnud2w Background: Human Papilloma Virus (HPV) infection is the main cause of cervical cancer, a primary malignant tumor developing from squamous epithelial cells. HPV expresses oncoproteins E6 and E7, known to inactivate tumor suppressor proteins, one of which is protein 53 (p53). A promising biomarker for diagnosing and prognosis malignancies brought on by the HPV genotype is the identification of p53. This study investigates the association between p53 expression and HPV genotype in cervical cancer patients. Method: This observational cross-sectional study involved patients diagnosed with cervical cancer on histopathological examination who met the requirements. The polymerase chain reaction (PCR) method was used to determine the HPV genotype, and an immunohistochemistry analysis was used to assess the level of p53 expression. A Chi-Square test is utilized to evaluate the association between the two variables. Results: Of the 49 patients, there were 7 (14.3%) patients with HPV type 16, 13 (26.5%) with HPV type 18, 14 (26.5%) other types of HPV and 15 (30.6%) negatives for HPV. Examination of p53 expression showed that 17 (34.6%) samples had &lt;10% expression, 17 (34.6%) had 10-50% expression, and 15 (30.8%) samples had &gt;50% expression. There was no correlation between p53 expression and HPV genotype (p = 0.071). However, an association between p53 expression and cervical cancer's clinical stage was identified (p = 0.028). Conclusion: Increased cervical cancer stage can be associated with increased p53 expression. Thus, p53 can be used as a predictor of cervical cancer stage. However, in cervical cancer, p53 expression cannot be associated with the HPV genotype.

Interactions of EGFR/PTEN/mTOR-Pathway Activation and Estrogen Receptor Expression in Cervical Cancer.

(1) Objective: Late-line chemotherapy rechallenge in recurrent cervical cancer is associated with modest therapy response but significant side effects. As mTOR pathways modulate cellular growth via estrogen receptor (ER) signaling and combined mTOR and ER inhibition previously demonstrated survival benefits in breast cancer, this exploratory study evaluates mTOR pathway and ER expression interactions in a preclinical cervical cancer model. (2) Methods: Immunostaining of a 126-tumor core tissue microarray was performed to assess phosphorylated-mTOR and ER expression. To identify tumor subsets with different clinical behavior, expression results were matched with clinicopathologic patient characteristics, and both univariate and multivariable survival statistics were performed. (3) Results: phosphorylated-mTOR correlates with ER (r = 0.309, p < 0.001) and loss of PTEN expression (r = -2.09, p = 0.022) in tumor samples across stages but not in matched negative controls. Positive ER expression is observed significantly more often in phosphorylated-mTOR positive samples (30.0% vs. 6.3%, p = 0.001). In the subgroup of phosphorylated-mTOR positive tumors (n = 60), ER expression is associated with improved survival (p = 0.040). (4) Conclusion: ER expression appears closely intertwined with EGFR/PTEN/mTOR-pathway activation and seems to define a subgroup with clinically distinct behavior. Considering limited therapeutic options in recurrent cervical cancer, further validation of combined mTOR and ER inhibition in selected patients could appear promising.

Twist1‑mediated transcriptional activation of Claudin‑4 promotes cervical cancer cell migration and invasion.

Claudin-4, a member of the claudin multigene family, participates in events associated with mesenchymal-like activity of cancerous cells. Claudin-4 expression is upregulated in cervical cancer tissue compared with that in adjoining non-neoplastic tissue. However, the mechanisms that regulate Claudin-4 expression in cervical cancer are poorly understood. Moreover, whether Claudin-4 contributes to the migration and invasion of cervical cancer cells remains unclear. By western blotting, reverse transcription-qPCR, bioinformatics analysis, dual-luciferase reporter assay, chromatin immunoprecipitation assay, wound healing assay and Transwell migration/invasion assay, the present study confirmed that Claudin-4 was a downstream target of Twist1, a helix-loop-helix transcriptional factor, the activity of which has a positive correlation with Claudin-4 expression. Mechanistically, Twist1 directly binds to Claudin-4 promoter, resulting in the transactivation of expression. The depletion of the Twist1-binding E-Box1 domain on Claudin-4 promoter via CRISPR-Cas9 knockout system downregulates Claudin-4 expression and suppresses the ability of cervical cancer cells to migrate and invade by elevating E-cadherin levels and lowering N-cadherin levels. Following activation by transforming growth factor-β, Twist1 induces Claudin-4 expression, thus enhancing migration and invasion of cervical cancer cells. In summary, the present data suggested that Claudin-4 was a direct downstream target of Twist1 and served a critical role in promoting Twist1-mediated cervical cancer cell migration and invasion.

Effects of micro-colloidal Rhodomyrtus tomentosa on MMP9, GLUT-1, and IL-1β expression in Rattus norvegicus cervical cancer

Context: Rhodomyrtus tomentosa has the potential to contain compounds that enhance health. One type of disease that requires antioxidants in its healing is cancer. R. tomentosa extract was resized to nano size to optimize cell permeability. Aims: To analyze the effects of micro-colloidal leaves extract of R. tomentosa (MR) on MMP9, GLUT-1, and IL-1β expression in cervical cancer. Methods: Wistar rats were divided into five treatments, namely untreated (C-), cervical cancer (C+), and a cervical cancer rat model that was given R. tomentosa extract (MR) 100 mg/kg (MR100), 200 mg/kg (MR200), and 400 mg/kg (MR400). After receiving the extract for 30 days, all groups were analyzed using an immunohistochemical technique to detect MMP9, GLUT-1, and IL-1β antibodies. Results: From the statistical analysis, there was a substantial difference in the expression of MMP9, GLUT-1, and IL-1 in the C+ group compared to the C-, MR100, MR200, and MR400 groups (p&lt;0.005; p&lt;0.002: p&lt;0.001 p&lt;0.01, respectively). Unrestrained cell development, asymmetric cell shape, a sizeable nucleus-to-cytoplasm ratio, and various nucleus-form variants, and when MR was administered, the cervical histology of the tissues began to improve, similar to group C. In this group decreases the distance between the tumors, slows the growth of the carcinoma, and permits the nucleus to form appropriately in a cervical cancer cell was observed. Dosages of 200 and 400 mg/kg improved the histology of cervical tissue while decreasing MMP-9, GLUT-1, and IL-1β expression. Conclusions: Rhodomyrtus tomentosa ethanolic extract shows antimetastatic properties and could be analyzed as an anticancer therapy in the future.

E6/E7 Oncogenes Mutation of Human Papillomavirus Type 16 Associated with P16 Protein Expression in Cervical Cancer

The genetic composition of the E6 and E7 oncogenes is very susceptible to mutation. Mutations occur due to interactions between the viral genome and the host. Changes in one nucleotide oncogenes E6 and E7 can affect the function of these oncogenes so that they can trigger the persistence of Human Papilloma Virus (HPV) infection and cervical cancer progression in several intratypic variants of HPV type 16 and alteration p16 expression in cervical cancer cases. This study was conducted on cervical cancer women first diagnosed from May 2021 to November 2021 who had not received surgery, chemotherapy, or radiation therapy. Willing to participate in the study after signing the informed consent. Cervical tissue samples with a positive test result for HPV 16 were then grouped based on the mutation sequencing of E6 and E7 into a wild-type group and a mutant group. Furthermore, the immunohistochemical examination was carried out to assess the expression of p16 protein in paraffin blocks. The results of this study showed that there was no association between mutations in the E6 and E7 oncogenes of HPV Type 16 with p16 expression (c= 0.048 and p value 0.78). The expression of p16 was stronger in the mutant group with the median percentage of cells from p16 immunohistochemistry staining which was 60.5% (range 3-73%) in the mutant group and 53% (range 2-65%) in the wild type of group. However, the correlation coefficient interval between HPV type 16 and E6 oncogene mutations with p16 protein expression is very weak.

Abstract 6531: Point of care test for cervical cancer screening

Abstract Cervical cancer is a lethal gynecological malignancy and the fourth most common cancer among women. Most high-grade cervical pre-cancers and cancer cases are linked to infection with high-risk human papillomaviruses (HPV). There is an inequity between high-income countries (HICs) and low- and middle-income countries (LMICs) in cervical cancer burden; according to the World Health Organization, the estimated mortality rate of cervical cancer is 342,000 women worldwide in 2020, and 90% of these women reside in low- and middle-income nations where the human papillomavirus vaccine is unavailable and access to early detection testing are either unavailable or too expensive. This study aims to develop a simple and affordable point-of-care test based on four critical biomarkers for screening high-risk pre-cancer and invasive cervical cancer in collaboration with the biomedical engineering department. A cervical cancer swab will be used in the test. The swab will be placed on a paper-based device that looks for four protein biomarkers critical for the progression of noninvasive cervical cancer into invasive cervical cancer by combining two approaches using proteomics and lateral flow immunochromatography technology. We have validated the markers' expression in cervical cancer and precancerous tissues. The four markers were expressed in squamous cell carcinoma, glassy cell carcinoma, adenocarcinoma, clear cell carcinoma cancer tissues, and the high-grade cervical intraepithelial neoplasia. This point-of-care test will be affordable and implementable, especially in low and middle-income countries. Citation Format: Samrin Farouk Idris Habbani, Sayeh Jalali Dowlatshahi, Monisha Elumalai, Scott Charles Bolton, Lucy Teberh Tecle, Pankti Rajesh Thakkar, Jacqueline C Linnes, Sulma I Mohammed. Point of care test for cervical cancer screening [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 6531.

Association between mutant E6 and E7 Human Papilloma Virus Type 16 oncogenes with cyclin D1 expression in cervical cancer: Observational study in Bali

Background: Incidence of cervical cancer is higher in low- and middle-income countries, including Indonesia. In Asia, Indonesia ranks second both in mortality and incidence of cervical cancer. Infection by Human Papilloma Virus (HPV) type 16 is a known risk factor, especially with mutations of the E6 or E7 oncogene that lead to chronic infection and malignancy. Increase in cyclin D1 expression is found on cervical cancer cells, including those resistant to chemotherapy. The role of cyclic D1 in increasing cellular proliferation and decreasing apoptosis leads to cervical cancer. Methods: This study was a cross-sectional observational study carried out between August 2020 until August 2021 at Prof. Dr. I.G.N.G. Ngoerah Hospital, Denpasar, Bali, Indonesia. Samples were collected by consecutive sampling of eligible patients. Polyclinic patients newly diagnosed with cervical cancer and who gave informed consent were further examined. We determined their oncogene E6 and E7 HPV type 16 mutation patterns and their association with cyclin D1 expression using contingency coefficient correlation test. Other outcomes including age distribution, parturition history, BMI, pathological type, clinical stage, and E6/E7 mutation characteristics was also recorded. Results: We included 31 eligible subjects with cervical cancer and HPV type 16-positive, divided into mutant E6/E7 (n=12/31; 38.7%) and wild type (n=19/31;61.3%). Primary outcome of association between mutant oncogene and cyclin D1 expression was weak (c=0.283; p-value=0.1). Secondary outcome showed majority of age on 50 years old or over; normal or overweight BMI; squamous cell carcinoma was the most commonly found (n=28/31; 90%); and clinical stage II (n=18/31; 38%) in both groups. Conclusions: This study concluded that there is no association between mutation in the E6/E7 HPV type 16 oncogenes with cyclin D1 expression in patients with cervical cancer.

Retrospective Analysis of the Predictive Value of 18F-FDG PET/CT Metabolic Parameters for PD-L1 Expression in Cervical Cancer

Immunotherapy targeting PD-1/PD-L1 has been proven to be effective for cervical cancer treatment. To explore non-invasive examinations for assessing the PD-L1 status in cervical cancer, we performed a retrospective study to investigate the predictive value of 18F-FDG PET/CT. The correlations between PD-L1 expression, clinicopathological characteristics and 18F-FDG PET/CT metabolic parameters were evaluated in 74 cervical cancer patients. The clinicopathological characteristics included age, histologic type, tumor differentiation, FIGO stage and tumor size. The metabolic parameters included maximum standard uptake (SUVmax), mean standard uptake (SUVmean), total lesion glycolysis (TLG) and tumor metabolic volume (MTV). In univariate analysis, SUVmax, SUVmean, TLG, tumor size and tumor differentiation were obviously associated with PD-L1 status. SUVmax (rs = 0.42) and SUVmean (rs = 0.40) were moderately positively correlated with the combined positive score (CPS) for PD-L1 in Spearman correlation analysis. The results of multivariable analysis showed that the higher SUVmax (odds ratio = 2.849) and the lower degree of differentiation (Odds Ratio = 0.168), the greater probability of being PD-L1 positive. The ROC curve analysis demonstrated that when the cut-off values of SUVmax, SUVmean and TLG were 10.45, 6.75 and 143.4, respectively, the highest accuracy for predicting PD-L1 expression was 77.0%, 71.6% and 62.2%, respectively. The comprehensive predictive ability of PD-L1 expression, assessed by combining SUVmax with tumor differentiation, showed that the PD-L1-negative rate was 100% in the low probability group, whereas the PD-L1-positive rate was 84.6% in the high probability group. In addition, we also found that the H-score of HIF-1α was moderately positively correlated with PD-L1 CPS (rs = 0.51). The SUVmax and differentiation of the primary lesion were the optimum predictors for PD-L1 expression in cervical cancer. There was a great potential for 18F-FDG PET/CT in predicting PD-L1 status and selecting cervical cancer candidates for PD1/PD-L1 immune checkpoint therapy.

Targeting self-enhanced ROS-responsive artesunatum prodrug nanoassembly potentiates gemcitabine activity by down-regulating CDA expression in cervical cancer

Prodrug self-delivery carriers with targeting that specifically responded to tumor microenvironments have good potential to improve the application dilemma of approved clinical therapeutic drugs (systemic distribution and side effects). It's noted the conversion of gemcitabine (GEM) to inactive ingredients under the action of cytidine deaminase (CDA) during metabolism in vivo limits its clinical effect. A high level of reactive oxygen species (ROS) results in a high level of oxidative stress in tumor cells, which changes the expression of CDA and optimizes the metabolism of GEM in vivo and overcome drug resistance. In this study, the ROS responsive and ROS self-supplied prodrug of artemisia (ART)-thioacetal bond (TK)-GEM was synthesized and self-vectors based on ART-TK-GEM (TK@FA NPs) was prepared by using nano precipitation. ROS responsive characteristics ensure specific release of prodrugs in tumor cells with high level of ROS thereby reducing side effects on normal cells and tissues. The endogenous ROS and newly generated ROS by ART can reduce the expression of CDA and optimizes the metabolism of GEM, and the accumulated ROS can also induce apoptosis of tumor cells, realizing synergistic anti-tumor effect of chemical drugs and traditional Chinese medicines. This paper proposes a simple method by using clinically approved drugs to improve the insufficient effect of existing chemotherapy and overcome resistance, which has potential to appropriately shorten the drug development cycle and accelerate the clinical investigation of drugs.

Foxo3a-Mediated DNMT3B Impedes Cervical Cancer Cell Proliferation and Migration Capacities through Suppressing PTEN Promoter Methylation

Objective Cervical cancer is linked with the constitutive activation of growth factors and gene mutations-induced pro-survival signaling pathways. Herein, we purposed to explore the possible molecular mechanism of Foxo3a-mediated DNMT3B in the proliferation and migration of cervical cancer cells via mediating the PTEN promoter methylation. Methods Foxo3a expression in cervical cancer was tested by qRT-PCR and western blot experiments. The cervical cancer cell biological functions with overexpression of Foxo3a were evaluated by CCK-8 assay, Transwell experiment, and flow cytometry, respectively. MS-PCR was utilized for testing the PTEN methylation levels, and ChIP experiment was implemented for evaluating the enrichment of DNMT3B in the PTEN promoter region and the binding of Foxo3a and DNMT3B. The PTEN methylation and interference with Foxo3a expression were performed in cervical cancer cells, and then their impacts on cervical cancer cell biological functions were observed. Results FOXO3a was expressed at a low level in cervical cancer, and its overexpression contributed to a reduction in cell proliferative, migratory and invasive capabilities, and an elevation in apoptosis rate. Foxo3a blocked its methylation with the PTEN promoter by repressing DNMT3B activity. Upon treatment with methyltransferase inhibitor (5-aza-dc), the malignant phenotypes of cervical cancer cells were diminished. 5-aza-dc neutralized the impacts of silencing Foxo3a on malignant phenotypes. Conclusion This research underlines that Foxo3a blocks its methylation with the PTEN promoter by inhibiting DNMT3B activity, which subsequently impedes cervical cancer cell progression.

FOXP3 Isoforms Expression in Cervical Cancer: Evidence about the Cancer-Related Properties of FOXP3Δ2Δ7 in Keratinocytes.

Cervical cancer (CC) is the fourth most common type of cancer among women; the main predisposing factor is persistent infection by high-risk human papillomavirus (hr-HPV), mainly the 16 or 18 genotypes. Both hr-HPVs are known to manipulate the cellular machinery and the immune system to favor cell transformation. FOXP3, a critical transcription factor involved in the biology of regulatory T cells, has been detected as highly expressed in the tumor cells of CC patients. However, its biological role in CC, particularly in the keratinocytes, remained unclarified. Therefore, this work aimed to uncover the effect of FOXP3 on the biology of the tumoral cells. First, public databases were analyzed to identify the FOXP3 expression levels and the transcribed isoforms in CC and normal tissue samples. The study's findings demonstrated an increased expression of FOXP3 in HPV16+ CC samples. Additionally, the FOXP3Δ2 variant was detected as the most frequent splicing isoform in tumoral cells, with a high differential expression level in metastatic samples. However, the analysis of FOXP3 expression in different CC cell lines, HPV+ and HPV-, suggests no relationship between the presence of HPV and FOXP3 expression. Since the variant FOXP3Δ2Δ7 was found highly expressed in the HPV16+ SiHa cell line, a model with constitutive expression of FOXP3Δ2Δ7 was established to evaluate its role in proliferation, migration, and cell division. Finally, RNAseq was performed to identify differentially expressed genes and enriched pathways modulated by FOXP3Δ2Δ7. The exogenous expression of FOXP3Δ2Δ7 promotes cell division, proliferation, and migration. The transcriptomic analyses highlight the upregulation of multiple genes with protumor activities. Moreover, immunological and oncogenic pathways were detected as highly enriched. These data support the hypothesis that FOXP3Δ2Δ7 in epithelial cells induces cancer-related hallmarks and provides information about the molecular events triggered by this isoform, which could be important for developing CC.

The pan cancer analysis identified DIAPH3 as a diagnostic biomarker of clinical cancer.

This study aimed to determine prognostic biomarkers of cervical cancer by pan-cancer analysis. Common differentially expressed genes in Gene Expression Omnibus and The Cancer Genome Atlas (TCGA) database were demonstrated using R software analysis, and these genes were enriched by the Kyoto Encyclopedia of Genes and Genomes and Gene Ontology. Genes with prognostic value were identified by least absolute contraction and selection regression, Cox regression, and survival analysis, and pan-cancer analysis was conducted using the Tumor Immune Estimation Resource database and TCGA database. Western blot, qRT-PCR, and immunohistochemistry were used to preliminarily verify its expression in cervical cancer (S1). The prognostic marker Diaphanous Related Formin 3 (DIAPH3) was obtained from us. The enrichment analysis revealed that DIAPH3 was involved in tumor proliferation, invasion, and inflammation. The pan-cancer analysis revealed that it was highly expressed in various cancers. Immune infiltration analysis revealed that its expression was related to B cells, effector T cells, and macrophage infiltration; however, immune checkpoint correlation analysis and tumor mutation burden analysis revealed the correlation between gene expression and immunotherapy. The expression of DIAPH3 in cervical cancer was significantly different from that in normal cervical tissues. The expression of DIAPH3 in cervical cancer was significantly increased, which may be related to the proliferation, metastasis, immune invasion, and immunotherapy of cervical cancer.