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Decreased Expression of EIF4A1 After Preoperative Brachytherapy Predicts Better Tumor-Specific Survival in Cervical Cancer

Liang, Shanhui PhD; Zhou, Yuqi MD; Chen, Yiran MD; Ke, Guihao MD; Wen, Hao MD; Wu, Xiaohua MD, PhD

International Journal of Gynecological Cancer: June 2014 - Volume 24 - Issue 5 - p 908–915
doi: 10.1097/IGC.0000000000000152
Cervical Cancer

Objective The aim of this study is to investigate whether EIF4A1, EIF4E, and EIF4G1 can serve as prognostic markers for patients with cervical cancer receiving preoperative brachytherapy.

Materials and Methods Tissue microarrays composed of 35 normal cervix samples, 87 cervical cancers treated without preoperative therapy, and 50 pairs of cervical cancer tissues collected before and after preoperative brachytherapy were constructed and evaluated for the expression of EIF4A1, EIF4E, and EIF4G using immunohistochemistry. Immunohistochemical staining was scored by the staining intensity and the percentages of tumor cells. The χ2 test was used to analyze the association between the immunohistochemistry results and clinicopathologic variables. The Kaplan-Meier method was applied to analyze the disease-specific survival.

Results Overexpression of EIF4A1, EIF4E, and EIF4G1 were detected in 83.9%, 84.7%, and 80.3% of cervical cancers, respectively, all of which were significantly related to advanced International Federation of Gynecology and Obstetrics stage, squamous cell histology, lymph node metastasis, and deep stromal invasion (P < 0.05). The altered expression pattern of EIF4A1 and EIF4E after preoperative brachytherapy was significantly correlated with the cervical cancer response to brachytherapy (P = 0.029 and 0.012, respectively). The decreased expression of EIF4A1 predicted better tumor-specific survival (P = 0.02). The alteration of EIF4A1 was an independent predictor for tumor-specific survival (P = 0.047; hazards ratio, 0.272; 95% confidence interval, 0.076–0.982).

Conclusions Overexpression of EIF4A1, EIF4E, and EIF4G1 were acquired malignant phenotypic features of cervical cancer. EIF4A1 might function as a novel prognostic indicator and a potential therapeutic target for cervical cancer.

From the Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center; and Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.

Address correspondence and reprint requests to Xiaohua Wu, MD, PhD, Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, 270 Dong-an Rd, Shanghai, 200032, China. E-mail:;

The authors declare no conflicts of interest.

Dr’s Shanhui Liang and Yuqi Zhou are co-first authors.

Received February 27, 2013

Accepted March 23, 2014

© 2014 by the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology.