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Embryonic stem cell markers Sox-2 and OCT4 expression and their correlation with WNT signal pathway in cervical squamous cell carcinoma.

BACKGROUND
Both the expression of embryonic stem cells (ESCs) markers (Sox2, Oct4) and the Wnt signal pathway (β-catenin) are crucial for progression of various human malignancies. The purpose of this study was to investigate the clinicopathologic significance of Sox2, Oct4 and β-catenin in cervical squamous cell carcinoma (CSCC) and to study their correlation with the occurrence and prognosis.


METHODS
Sox2, Oct4 and β-catenin were assessed using immunohistochemistry in normal cervix tissues (n=28) and invasive cervical squamous cell carcinoma (n=43). Associations of Sox2, Oct4 and β-catenin levels with clinicopathological characteristics and with overall survival were studied using uni- and multivariate analysis.


RESULTS
The expression levels of Sox2, Oct4 and β-catenin were highly increased in CSCC compared with the normal cervix tissues. The ESCs markers expression (Sox2 and Oct4) correlated significantly with β-catenin expression. High expression of Sox2, but not that of Oct4 or β-catenin, was correlated with poorer differentiation (P<0.05). Furthermore, Sox2 expression was significantly correlated with patients' status of survival in advanced CSCC (P<0.05), whereas there was no significant finding in Oct4 or β-catenin expression.


CONCLUSIONS
These findings provide evidence that both ESCs biomarkers (Sox2, Oct4) and Wnt signal pathway (β-catenin) are activated in CSCC. Sox2 can be regarded as a novel predictor of poor prognosis for CSCC patients.