Association of CXCR4 and CCR7 chemokine receptor expression and lymph node metastasis in human cervical cancer

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Abstract
Background: The chemokine receptors CXCR4 and CCR7 have been suggested to play an important role in cancer invasion and metastasis. The expression of these receptors in human cervical cancer, however, has seldom been characterized. Patients and methods: We investigated the expression of CXCR4 and CCR7 in cervical cancer specimens and determined the association between their expression and the clinicopathological features observed, including patient outcome. Results: CXCR4 expression was significantly higher in elderly patients (P = 0.025); it was also significantly increased in patients with cancers displaying large tumor size (P = 0.010), deep stromal invasion (P = 0.0004), lymph–vascular space involvement (P = 0.0002), or lymph node metastasis (P < 0.0001). CCR7 expression was significantly higher in cases of squamous cell carcinomas (P = 0.010) and in patients with cancers showing large tumor size (P < 0.0001), deep stromal invasion (P < 0.0001), vaginal invasion (P = 0.047), lymph–vascular space involvement (P = 0.012), or lymph node metastasis (P < 0.0001). Logistic regression analysis revealed that deep stromal invasion (P = 0.017) and CXCR4 (P = 0.016) and CCR7 (P = 0.022) expression were independent factors that influenced pelvic lymph node metastasis. The disease-free survival and overall survival (OS) rates of patients exhibiting both CXCR4 and CCR7 expression were significantly reduced (P < 0.0001). In addition, the expression of both CXCR4 and CCR7 was an independent prognostic factor for OS (95% confidence interval = 1.03–17.86; P = 0.046). Conclusions: CXCR4 and CCR7 expression may be associated with lymph node metastasis; moreover, the expression of these receptors can serve as an indicator of poor prognosis in patients with cervical cancer.