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Can Zhang,1,* Yong Li,1,* Rui Ji,1 Weiling Zhang,1 Chenfei Zhang,2 Youli Dan,3 Hongyan Qian,4 Aiqin He1 1Department of Gynecology Oncology, Tumor Hospital Affiliated to Nantong University, Nantong, People’s Republic of China; 2Department of Medical Oncology, Tumor Hospital Affiliated to Nantong University, Nantong, People’s Republic of China; 3Department of Oncology, Medical College of Nantong University, Nantong, People’s Republic of China; 4Cancer Research Centre Nantong, Tumor Hospital Affiliated to Nantong University, Nantong, People’s Republic of China*These authors contributed equally to this workCorrespondence: Aiqin HeDepartment of Gynecology Oncology, Tumor Hospital Affiliated to Nantong University, 30 Tongyang North Road, Nantong 226300, People’s Republic of ChinaTel +86 139 6293 1600Fax +86 513 8671 2287Email haq0118@163.comHongyan QianCancer Research Centre Nantong, Tumor Hospital Affiliated to Nantong University, 30 Tongyang North Road, Nantong 226300, People’s Republic of ChinaTel/Fax +86 513 8671 2287Email qhy672041647@163.comBackground: Pretreatment albumin/alkaline phosphatase ratio (AAPR) has been discussed about its prognostic value in several malignancies, whereas its role in cervical cancer remains unclear. In this study, we attempt to explore the prognostic significance of the AAPR in stage IB-IIA cervical cancer patients who underwent a radical hysterectomy.Patients and methods: A total of 230 cervical cancer patients were enrolled in this retrospective study. The threshold value of AAPR was determined by receiver operating characteristic (ROC) curve. Kaplan-Meier survival analysis and multivariate analysis were performed to identify independent prognostic predictors of disease-free survival (DFS) and overall survival (OS).Results: The optimal cut-off value of the preoperative AAPR was 0.68. Patients with AAPR0.68 according to Kaplan-Meier curves (DFS: P = 0.011; OS: P = 0.017). In multivariate analysis, the preoperative AAPR showed to be an independent predictive factor for disease-free survival (DFS: P = 0.015) and overall survival (OS: P = 0.019). Moreover, subgroup analysis revealed that the lower AAPR was correlated with worse prognosis in patients with histologic grade I-II; but in those with histologic grade III, there was no significant difference between the two groups.Conclusion: Preoperative AAPR was a potentially valuable prognostic index in stage IB-IIA cervical cancer patients. Further prospective studies are required to validate its prognostic value.Keywords: albumin-to-alkaline phosphatase ratio, uterine cervical neoplasms, prognosis, survival analysis

Genetic variants in miRNAs have attracted more and more attention these years because they are capable of altering miRNA function and/or expression, consequently affecting downstream biological pathways and disease risk. The rs767649 polymorphism, locating in the promoter of miR-155, was recently reported to be able to alter transcriptional activity of miR-155 and relate to lung cancer risk. In this study, we aimed to assess the relationship between rs767649 and cervical cancer (CC) risk. We investigated the association of rs767649 with CC risk in a two-stage case-control study with 1157 cases and 1280 controls. Genotyping was determined with TaqMan allelic discrimination method. The results showed that the rs767649 TT genotype was associated with a significantly reduced risk of CC in both test (549 cases and 603 controls), validation (608 cases and 677 controls) and combined sets [adjusted odds ratio (OR) = 0.67, 95% confidence interval (CI) = 0.51–0.87 for the combined set] compared with the AA/AT genotypes. Moreover, the association was more prominent among patients of age > 49 years and postmenopausal status (OR = 0.56, 95% CI = 0.38–0.83, and 0.60, 0.40–0.89, respectively) and patients with clinical stage I and II CC (OR = 0.67, 95% CI = 0.50–0.91, and 0.60, 0.40–0.92, respectively). Further analyses showed that miR-155 was overexpressed in the CC tissues as compared with normal tissues, suggesting an oncogenic role in CC. Luciferase assay indicated that the transition of A to T allele might lead to miR-155 downregulation at the transcriptional level. In conclusion, rs767649 might be a causal variant for CC susceptibility.