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. 2018 Feb 24:24:1145-1151.
doi: 10.12659/msm.905902.

Prognostic Significance of Zinc Finger E-Box-Binding Homeobox Family in Glioblastoma

Peng Chen  1 , Hongxin Liu  1 , Aiwu Hou  1 , Xibo Sun  1 , Bingxuan Li  1 , Jianyi Niu  1 , Lingling Hu  2
Affiliations

Prognostic Significance of Zinc Finger E-Box-Binding Homeobox Family in Glioblastoma

Peng Chen et al. Med Sci Monit. .

Abstract

BACKGROUND Epithelial-mesenchymal transition (EMT) is an essential progress for tumor cell invasion to both epithelial and non-epithelial cancers, and zinc finger E-box-binding homeobox 1/2 (ZEB1/2) is a well-known promoter of EMT. In glioma cell lines, both ZEB1 and ZEB2 have been demonstrated to facilitate cancer cell proliferation and invasion with experiments in vitro. However, the clinical significance of ZEB1 and ZEB2 in glioblastoma (GBM) is still controversial. MATERIAL AND METHODS We detected the expression of ZEB1 and ZEB2 in 91 cases of GBM with immunohistochemistry and investigated the correlation between clinicopathological factors and ZEB family expression with Fisher test. By univariate analysis with Kaplan-Meier test, we explored the prognostic significance of ZEB1/2 expression and the clinicopathological factors in GBM. By multivariate analysis with the Cox regression model, we identified the independent prognostic factors in GBM. RESULTS The percentages of ZEB1 high expression and ZEB2 high expression were 31.9% (29/91) and 41.9% (36/91), respectively. High expression of ZEB2 was significantly associated with lower survival rate of GBM patients (P=0.001). ZEB2, lower KPS score (P=0.004), gross total resection (P<0.001) and higher Ki67 percentage (P=0.001) were notably correlated to worse prognosis of GBM. With multivariate analysis, high expression of ZEB2 was demonstrated to be an independent prognostic factor indicating unfavorable prognosis of GBM (P=0.001, HR=3.86, and 95%CI=1.61-9.23). CONCLUSIONS High expression of ZEB2 is an independent prognostic factor predicting unfavorable prognosis of GBM, indicating that ZEB2 or its downstream proteins may be potential drug targets of GBM therapy.

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Conflict of interest statement

Conflicts of interest

None.

Figures

Figure 1
Figure 1
The representative images of ZEB1 and ZEB2 expression. (A) Upper panel: Representative image of ZEB1 high expression. Bottom panel: magnified image of ZEB1 high expression. (B) Upper panel: Representative image of ZEB2 high expression. Bottom panel: magnified image of ZEB2 high expression. Scale bar 50 μm.
Figure 2
Figure 2
The survival curves of high expression and low expression of ZEB1 or ZEB2. (A) The survival curves of high expression and low expression of ZEB1. The survival rates of patients with high or low ZEB1 expression had no statistical significance (P=0.279). (B) The survival curves of high expression and low expression of ZEB2. Patients with high ZEB2 expression had significantly lower survival rates compared with those with low ZEB2 expression (P=0.001).
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