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Objective To investigate the expression changes and significance of fork box protein C1 (FOXC1) in human epithelial ovarian cancer (EOC). Methods The expression of FOXC1, E-cadherin and Vimentin in 30 cases of benign EOC tissues, 30 cases of borderline ECO tissues and 70 cases of ECO tissues was detected by immunohistochemical SP staining. The ovarian cancer patients were followed up for 3 years, and the 3-year cumulative survival rate was compared between ovarian cancer patients with positive and negative FOXC1, E-cadherin and Vimentin. Results(1)The positive expression rates of FOXC1 and E-cadherin in the borderline ECO tissues were decreased,and the positive expression rate of Vimentin was increased as compared with those of the benigh ECO tissues (P < 0. 05). (2) The positive expression rate of E-cadherin was 28. 6% (20/70), the positive expression rate of Vimentin was 15. 7% (11/70) in ovarian cancer tissues with positive expression of FOXC1, the expression of FOXC1 was positively correlated with the expression of E-cadherin (r= 0. 446, P = 0. 000), and was correlated with Vimentin expression (r =-0. 295, P = 0. 014). (3) The expression of FOXC1 protein in EOC tissues was negatively correlated with lymph node metastasis, dualistic type and grading, and the protein expression of E-cadherin and Vimentin was correlated with lymph node metastasis, clinical classification,dualistic type and grading (all P < 0. 05). (4) The 3-year cumulative survival rates of EOC patients with positive expression of FOXC1 and E-cadherin was 82. 1% and 80. 6%, respectively,which were higher than those in patients with negative expression of FOXC1 and E-cadherin (69. 0% and 69. 2%). The 3-year cumulative survival rates of EOC patients with positive expression of Vimentin was 70%, which was significantly lower than that in patients with negative Vimentin (80%) (all P < 0. 05). Conclusions The expression of FOXC1 is decreased in ovarian cancer tissues, and the loss expression of FOXC1 may be a role in the process of EMT. Meanwhile, FOXC1 expression may be involved in the occurrence and development of ovarian cancer and can be used as an indicator to evaluate prognosis. [ABSTRACT FROM AUTHOR]