FGF23 is a potential prognostic biomarker in uterine sarcoma

BackgroundUterine sarcoma (US) is a highly malignant cancer with poor prognosis and high mortality in women. In this study, we evaluated the expression of human fibroblast growth factor 23 (FGF23) in different US subtypes and the relationship between survival and clinicopathological characteristics. MethodsWe conducted a comparative analysis of FGF23 gene expression in different pathological types of US. Utilizing a cohort from The Cancer Genome Atlas (TCGA) of 57 patients, a 50-patient microarray dataset (GSE119043) from the Gene Expression Omnibus (GEO) and a clinical cohort of 44 patients, we analyzed gene expression profiles and corresponding clinicopathological information. Immunohistochemistry (IHC) was used to examine the expression level of FGF23 in four US subtypes. Survival analysis was used to assess the relationship between FGF23 expression and prognosis in US patients. ResultsCompared with uterine normal smooth muscle (UNSM) and uterine leiomyoma (ULM), FGF23 expression was significantly upregulated in US and was differentially expressed in four US subtypes. Uterine carcinosarcoma (UCS) exhibited the highest expression of FGF23 among the subtypes. Survival analysis indicated that FGF23 expression was unrelated to overall survival and progression-free survival in US (P>0.05). Similar results were obtained from the validation cohorts. Univariate and multivariate analyses showed no significant correlation between FGF23 expression and the US prognosis. Tumor stage, CA125 and tumor recurrence were independent prognostic factors for survival of US patients. ConclusionFGF23 was highly expressed in uterine sarcoma and was promising as a novel potential biomarker for the diagnosis and prognosis of uterine sarcoma.