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Weak Expression of Focal Adhesion Kinase (pp125FAK) in Patients with Cervical Cancer Is Associated with Poor Disease Outcome

Authors' Affiliations: Departments of ¹ Obstetrics and Gynecology and ² Pathology, Freiburg University Medical Center, Freiburg, Germany; ³ Department of Pediatrics, Rostock University Medical Center, Rostock, Germany; ⁴ Department of Obstetrics and Gynecology, Medical Faculty Hospital, Plzen, Czech Republic; and ⁵ Department of Obstetrics and Gynecology, University of Vienna, Vienna, Austria

Requests for reprints: Boris Gabriel, Department of Obstetrics and Gynecology, Freiburg University Medical Center, Hugstetter Str. 55, D-79106 Freiburg i. Br, Germany. Phone: 49-761-270-3024; Fax: 49-761-270-2932; E-mail: bGabriel{at}frk.ukl.uni-freiburg.de.

Purpose: The pp125 focal adhesion kinase (FAK) plays a pivotal role in tumor cell signaling. FAK expression has been linked to tumor cell invasion and metastasis, but data on cervical cancer are inconclusive. Our goal was to investigate FAK expression in cervical cancer and to assess whether its expression correlates with prognosis.

Experimental Design: FAK expression was examined using immunohistochemistry with sections from 162 resected cervical cancer specimens. Kaplan-Meier survival curves were used to determine the significance of FAK expression in the prognosis of cervical cancer patients.

Results: Specific FAK expression was found in the tumor cells, whereas normal cervical epithelium showed barely any FAK expression. Of 162 invasive cervical cancer specimens, 55 (34%) revealed weak expression of FAK, whereas moderate and strong expression was found in 63 (39%) and 44 (27%) tumors, respectively. Patients with tumors expressing weak amounts of FAK were characterized by a significantly poorer overall survival compared with those with moderate and high intratumoral FAK expression (P = 0.002). Weak expression of FAK correlated with pelvic lymph node metastasis (P = 0.026) and recurrent disease (P = 0.013). Multivariate Cox regression analysis revealed decreased FAK expression and pelvic lymph node metastasis to be significant independent factors predictive of poor disease outcome (hazard ratio, 0.36; P = 0.005; hazard ratio, 2.38; P = 0.018, respectively).

Conclusions: Weak expression of FAK in invasive cervical cancer is a strong independent predictor of poor patient outcome. Further studies are warranted to elucidate whether FAK expression analysis is a suitable tool identifying patients at high risk even at an early clinical stage.

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