Relationship between EZH2 expression and autophagy and its prognostic value in cervical squamous cell carcinoma

Objective To investigate the relationship between inhancer of zeste homolog 2 (EZH2) expression and autophagy and its prognostic value in cervical squamous cell carcinoma. Methods A total of 80 patients with cervical squamous cell carcinoma, 30 patients with cervical intraepithelial neoplasia (CIN) Ⅱ-Ⅲ, 30 patients with CIN Ⅰ, and 30 patients with chronic cervicitis were selected. Immunohistochemistry was used to detect the expression of EZH2, autophagy associated proteins Beclin-1 and microtubule-associated protein 1 light chain 3 (LC3) proteins in the cervical tissues of each group. The correlation between the three factors and the clinicopathological parameters of cervical squamous cell carcinoma was analyzed. Patients with cervical squamous cell carcinoma were followed up, and the Cox proportional hazard regression model was used to analyze the relationship between the protein expression levels of EZH2, Beclin-1 and LC3 and the survival of patients. Results The positive expression rates of EZH2 protein in cervical squamous cell carcinoma, CIN Ⅱ-Ⅲ, CIN Ⅰ and chronic cervicitis tissues were 78.8%, 60.0%, 33.3% and 10.0%, respectively (P<0.05), the positive expression rates of Beclin-1 protein were 27.5%, 70.0%, 76.7% and 86.7%, respectively (P<0.05), and the positive expression rates of LC3 protein were 30.0%, 70.0%, 73.3% and 80.0%, respectively (P<0.05). The expression level of EZH2 protein was significantly correlated with FIGO stage, differentiation degree, tumor size and lymph node metastasis of cervical squamous cell carcinoma (P<0.05), but not correlated with age (P>0.05). Beclin-1 and LC3 were significantly correlated with FIGO (International Federation of Gynecology and Obstetrics) stage and lymph node metastasis (P<0.05), but not with age, tissue differentiation degree, and tumor size (P>0.05). Correlation analysis showed that the protein expression levels of EZH2 were negatively correlated with Beclin-1and LC3 (r=-0.296, P＜0.01; r=-0.327, P＜0.01), while Beclin-1 was positively correlated with LC3 protein (r=0.391, P<0.01). Multivariate Cox regression analysis showed that EZH2, Beclin-1 and LC3 were independent risk factors for the prognosis of cervical squamous cell carcinoma patients. Conclusions The high expression of EZH2 in cervical squamous cell carcinoma tissues may be involved in the occurrence and development of cervical squamous cell carcinoma through inhibiting autophagy, thus affecting the prognosis of cervical cancer patients.