EGR1 promotes stemness and predicts a poor outcome of uterine cervical cancer by inducing SOX9 expression

Background Early growth response-1 (EGR1) is a transcription factor involved in the progression of several cancer types. However, the expression and clinical significance of EGR1 in uterine cervical cancer (CC) have not been elucidated. Objective To investigate the expression, clinical significance and prognostic value of EGR1 in CC. Methods The expression of EGR1 was detected in 13 CCs and paired adjacent tissues with qRT-PCR and in 144 CC tissues with immunohistochemistry (IHC). The IHC scores were used to divide the patients into subsets with low and high EGR1 expression. The correlations between the EGR1 expression and clinicopathological factors were analyzed with the chi-square test, and the prognostic significance of EGR1 expression was evaluated with univariate and multivariate analyses. The functions of EGR1 in the proliferation, invasion and stemness of CC cells were investigated, and the molecular mechanism was assessed by in vitro experiments. Results High expression of EGR1 was significantly associated with low survival rates of CC. EGR1 is an independent prognostic biomarker of CC, and its high expression predicted a poor outcome. EGR1 facilitated stemness and thus promoted proliferation and invasion of CC cells. SOX9 played an essential role in the EGR1-induced progression of CC cells. Conclusions EGR1 is an independent prognostic biomarker of CC. High EGR1 expression promoted proliferation, invasion and stemness by increasing SOX9 expression in CC cells. Our results suggested that the EGR1-SOX9 axis may be a potential drug target and that blocking the EGR1-SOX9 axis may be a possible approach to treating CC.