HPIP: a predictor of lymph node metastasis and poor survival in cervical cancer

Figures & data

Figure 1 Immunohistochemical staining of HPIP in cervical tissues (×400).

Notes: (A) Positive control in ovarian cancer; (B) low HPIP expression in normal cervical tissues; (C) high HPIP expression in cervical intraepithelial neoplasia; (D) low HPIP expression in cervical intraepithelial neoplasia; (E) high HPIP expression in cervical squamous cell carcinoma; (F) low HPIP expression in cervical squamous cell carcinoma; (G) high HPIP expression in cervical adenocarcinoma; and (H) low HPIP expression in cervical adenocarcinoma.

Table 1 Expression of HPIP in different cervical tissues

	Cases	HPIP expression status		P-value
		High (%)	Low (%)
Normal cervix	20	3 (15.0)	17 (85.0)	0.001a
Cervical intraepithelial neoplasia	20	5 (25.0)	15 (75.0)	0.429b
Cervical cancer	119	64 (53.8)	55 (46.2)	0.017c

Notes:

a Cervical cancer versus normal cervix, P=0.001;

b cervical intraepithelial neoplasia versus normal cervix, P=0.429;

c cervical cancer versus cervical intra-epithelial neoplasia, P=0.017.

Table 2 Relationships of HPIP expression status with clinico-pathological factors of cervical cancer

Variables	Patients	HPIP expression		P-value
		Low	High
All cases	119
Age (years)				0.921
<43	59	27	32
≥43	60	28	32
Histological type				0.236
SCC	106	51	55
Adenocarcinoma	13	4	9
Histological grade				<0.001
G1	23	14	9
G2	65	37	28
G3	31	4	27
FIGO stage				0.679
I	69	33	36
II	50	22	28
Depth of stromal infiltration				0.015
<1/2	68	38	30
≥1/2	51	17	34
Tumor size (cm)				0.218
<4	82	41	41
≥4	37	14	23
Lymph node metastasis				<0.001
No	94	52	42
Yes	25	3	22
LVSI				0.026
No	93	48	45
Yes	26	7	19
Recurrence				0.029
No	104	52	52
Yes	15	3	12

Abbreviations: FIGO, the Federation of Gynecology and Obstetrics; G1, well differentiated; G2, moderately differentiated; G3, poorly differentiated; LVSI, lymphovascular space invasion; SCC, squamous cell carcinoma.

Figure 2 Kaplan–Meier curves for the survival of prognosis in 119 patients with cervical cancer according to the categories of low and high expressions of HPIP (analyzed with log-rank test).

Notes: (A) Overall survival; (B) disease-free survival.

Table 3 Univariate survival analysis of 119 patients with cervical cancer

Variables	OS			DFS
	Mean ± SD	5 year (%)	P-value	Mean ± SD	5 year (%)	P-value
Age (years)			0.973			0.973
<43	74.5±2.8	79.7		74.1±2.9	79.2
≥43	76.3±3.0	78.3		75.1±3.3	77.7
Histological type			0.065			0.072
SCC	77.2±2.2	81.1		76.5±2.3	80.6
Adenocarcinoma	58.6±6.9	61.5		57.9±7.3	61.5
Histological grade			0.011			0.008
G1	82.3±2.3	95.7		82.2±2.4	95.5
G2	76.9±2.5	81.5		76.5±2.6	81.1
G3	65.4±5.2	61.3		63.2±5.6	60.2
FIGO stage			0.012			0.016
I	79.0±1.7	87.0		78.2±1.9	86.2
II	68.4±4.1	68.0		67.9±4.2	67.9
Depth of stromal infiltration			0.026			0.026
<1/2	80.9±1.9	85.3		80.1±2.2	84.9
≥1/2	66.1±3.7	70.6		65.6±3.8	70.1
Tumor size (cm)			0.029			0.034
<4	78.9±2.2	84.1		78.2±2.4	83.6
≥4	66.0±4.3	67.6		65.4±4.4	67.0
Lymph node metastasis			<0.001			<0.001
No	80.2±1.9	86.2		79.9±2.0	86.2
Yes	55.4±5.4	52.0		51.6±5.9	44.2
LVSI			<0.001			<0.001
No	80.2±1.9	84.9		79.6±2.0	84.6
Yes	57.0±5.8	57.7		55.9±5.9	56.7
HPIP expression status			0.003			0.002
Low	82.9±1.9	90.0		82.6±2.1	90.8
High	66.3±3.1	68.8		64.9±3.3	67.4

Abbreviations: DFS, disease-free survival; FIGO, the Federation of Gynecology and Obstetrics; G1, well differentiated; G2, moderately differentiated; G3, poorly differentiated; LVSI, lymphovascular space invasion; OS, overall survival; SCC, squamous cell carcinoma.

Table 4 Multivariate survival analysis of 119 patients with cervical cancer

Variables	OS			DFS
	HR	95% CI	P-value	HR	95% CI	P-value
FIGO stage	3.397	1.499–7.698	0.003	2.927	1.308–6.552	0.009
Lymph node metastasis	2.650	1.091–6.434	0.031	3.036	1.221–7.549	0.017
LVSI	2.738	1.145–6.550	0.024	2.462	1.014–5.975	0.046
HPIP expression status	3.153	1.140–8.723	0.027	2.901	1.038–8.107	0.042

Abbreviations: DFS, disease-free survival; FIGO, the Federation of Gynecology and Obstetrics; HR, hazard ratio; LVSI, lymphovascular space invasion; OS, overall survival.

Table 5 Multivariate analysis of the association of lymph node metastasis with HPIP expression status in cervical cancers

Variables	B	SE	P-value	OR	95% CI
Age (years)
<43
≥43	0.108	0.584	0.854	1.114	0.354–3.499
LVSI
No
Yes	2.004	0.546	<0.001	7.416	2.544–21.620
HPIP expression status
Low
High	2.047	0.680	0.003	7.746	2.043–29.365

Abbreviations: B and SE, the parameter estimator of the association coefficient and its standard error; LVSI, lymphovascular space invasion; OR, odds ratio.