HOXC6 expression is associated with a poor prognosis in early-stage cervical squamous cell carcinoma

Homeobox C6 (HOXC6) is involved in malignant progression in certain cancers. However, the expression profile of HOXC6 and its clinical/prognostic significance are unclear in early-stage cervical cancer. The mRNA and protein expression levels of HOXC6 were analyzed in five cervical cancer cell lines and four corresponding cervical cancer tumors by real-time PCR and Western blotting, respectively. Immunohistochemistry was performed to detect the expression of HOXC6 in paraffin-embedded tissues from 90 early-stage cervical cancer patients, 60 cervical intraepithelial neoplasia (CIN) patients and 19 normal cervical tissues (NCTs). Statistical analyses were used to evaluate the clinicopathological significance of HOXC6 expression. In this study, HOXC6 expression was differentially increased in cervical cancer cell lines and tissues than in normal tissues and ANTs. Moreover, its expression was significantly up-regulated at protein level in early-stage cervical cancer, compared to CIN and NCTs (P=0.004). Statistical analysis showed that HOXC6 expression was significantly correlated with tumor size (P=0.044), type of tumor growth (P=0.009), stromal invasion (P=0.030), lymph node metastasis (P=0.027), positive surgical margins (P=0.038), vaginal involvement (P=0.038), postoperative adjuvant therapy (P=0.012), recurrence (P=0.044) and survival (P=0.033). Kaplan-Meier analysis indicated that patients with higher HOXC6 expression had shorter overall survival duration than patients with lower HOXC6 expression. Cox-regression analysis demonstrated that HOXC6 expression was a factor significantly associated with the 5-year DFS and OS rates for 90 SCC patients. Our findings suggest that HOXC6 expression was associated with a poor prognosis in early-stage SCC, and it may serve as a prognostic biomarker.