Downregulated ECRG4 is correlated with lymph node metastasis and predicts poor outcome for nasopharyngeal carcinoma patients
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Esophageal cancer-related gene 4 (ECRG4) is a new candidate tumor suppressor gene. In this retrospective study, we evaluated ECRG4 protein expression in patients with nasopharyngeal carcinoma (NPC) under curative treatment and examined its association with pathological features and clinical outcomes as a possible biomarker for diagnosis and prognosis of NPC.
We enrolled 122 patients with a first diagnosis between January 2001 and December 2003. Tumor tissue and control tissue from biopsies underwent immunohistochemical staining for ECRG4. ECRG4 expression was analyzed by clinicopathological variables. After Kaplan–Meier survival analysis, we used Cox proportional hazards regression to estimate the predictive effect of ECRG4 expression on overall survival.
ECRG4 protein level was lower in NPC than control tissue (P < 0.01). It was inversely related to node status (P < 0.001) and clinical stage (P = 0.027). ECRG4 expression was associated with overall survival, and downregulated ECRG4 expression was an independent prognostic factor of poor survival (hazard ratio = 0.677, 95 % confidence interval 0.463–0.989, P = 0.044).
A significant NPC patients showed downregulated ECRG4 expression, which is correlated with lymph node metastasis. The marker could be an independent prognostic factor for NPC patients. The precise function of ECRG4 in the progression of NPC, especially for lymphatic metastasis, deserves further investigation, which would bring a new target for personalized therapy.
KeywordsNasopharyngeal carcinoma Esophageal cancer-related gene 4 Lymphatic metastasis Survival analysis Prognostic biomarker
This work was supported by the Medical Scientific Research Foundation of Guangdong Province, China, A2013392 (L. Peng) A2015383 (YT. Huang), Science and Technology Planning Project of Shantou, Guangdong, China, No.:(2013)244 (L. Zhou). We thank Prof. Kun Lin and Dr. Ku-sheng Wu for critical and helpful advice for the statistical analysis.
Compliance with ethical standards
All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ethics Committee of Shantou University Medical College and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, written consent was waived, while oral consent from the patients was obtained via telephone and documented by telephone recording.
Conflict of interest
The authors declare that they have no competing interests.
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