High-Level Expression of RIPK4 and EZH2 Contributes to Lymph Node Metastasis and Predicts Favorable Prognosis in Patients With Cervical Cancer

Abstract

The investigation of specific genes will establish more useful biomarkers for accurate detection and management of gynecological cancers, especially patients with cervical cancer (CCP). The aim of this study was to evaluate the expression level of RIPK4 and EZH2 messenger RNA (RIPK4 and EZH2 mRNA) in CCP. Expression of RIPK4 and EZH2 in the tissues was determined by immunohistochemistry and qRT-PCR methods. Correlations of RIPK4 and EZH2 mRNA with clinical and pathological parameters were analyzed using the Fisher’s exact test. The mRNA level of RIPK4 was significantly upregulated in tumor tissues compared with matched adjacent normal tissues (4.10 ± 0.89 vs. 1.5 ± 0.82; p = 0.021). EZH2 mRNA was increased in cancer tissues compared to normal tissues (3.54 ± 0.71 vs. 1.2 ± 0.65; p = 0.003). High expression of RIPK4 was observed in 25 patients (64.1%), whereas weak expression was seen in 14 cases (35.9%). Furthermore, the expression of RIPK4 was overexpressed in matched adjacent normal tissues (p = 0.004). FIGO stage and lymph node metastasis were significantly linked to a higher expression of RIPK4 (p < 0.05). Overexpression of EZH2 was found in 30 patients (76.9%) and was associated with FIGO stage, histological type, and lymph node metastasis (p < 0.05). In conclusion, our data suggest that RIPK4/EZH2 markers might be used as potential predictors of prognosis in cervical cancer.