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Fibronectin overexpression is associated with latent membrane protein 1 expression and has independent prognostic value for nasopharyngeal carcinoma

  • Research Article
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Tumor Biology

Abstract

Despite recent improvements in the diagnosis and treatment, the final outcomes in patients with nasopharyngeal carcinomas (NPC) still remain suboptimal. Through data mining from published transcriptomic database with further bioinformatic validation, fibronectin (FN1) was identified as a differentially upregulated gene in NPC tissues, which implicates the transition from epithelial to mesenchymal phenotype (EMT) and promotes metastasis. Given the roles of fibronectin in risk stratification and in the frontline therapeutics of common carcinomas, such as renal cell cancer, we explored fibronectin immunoexpression status and its associations with clinicopathological variables and survival in a well-defined cohort of NPC patients. Fibronectin immunohistochemistry was retrospectively performed and analyzed using H-score for 124 biopsy specimens from NPC patients who received standard treatment without distant metastasis at initial diagnosis. Those cases with H-score higher than the median value were regarded as fibronectin overexpression. The findings were correlated with clinicopathological variables, EBV latent membrane protein 1 (LMP1) expression, disease-specific survival (DSS), distant metastasis-free survival (DMFS), and local recurrence-free survival (LRFS). Fibronectin overexpression was significantly associated with American Joint Committee on Cancer (AJCC) stages III–IV (p = 0.019) and LMP1 expression (p = 0.004), and univariately predictive of adverse outcomes for DSS, DMFS, and LRFS (all p < 0.0001). In the multivariate comparison, fibronectin overexpression still remained prognostically independent to portend worse DSS (p < 0.01, hazard ratio = 5.958), DMFS (p < 0.01, hazard ratio = 5.728), and LRFS (p < 0.01, hazard ratio = 5.411) together with advanced AJCC stages III–IV. Fibronectin is upregulated in a subset of NPCs, and its increased immunoexpression significantly correlated with advanced features, justifying the potentiality of fibronectin as a theragnostic biomaker of NPC.

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Abbreviations

NPC:

Nasopharyngeal carcinomas

EBV:

Epstein–Barr virus

WHO:

World Health Organization

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Acknowledgments

This work was sponsored by Chi-Mei Medical Center (to C-F Li). The authors highly appreciated the BioBank of Chi-Mei Medical Center for providing the tumor samples.

Conflicts of interest

None.

Authors' contributions

L-J Ma, S-W Lee, T-Z Chen, and C-F Li collaborated in the conception and design of the study. K-Y Chang, H-Y Huang, and T-Z Chen developed the study methodology. L-C Lin, H-P Hsu, C-F Li acquired the data. T-J Chen, I-W Chang, and C-F Li analyzed and interpreted the data. L-J Ma, H-Y Huang, and C-F Li wrote and/or revised the manuscript. S-W Lee and C-F Li supervised the study.

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Authors and Affiliations

  1. Department of Pathology, Chi-Mei Foundation Medical Center, Tainan, Taiwan

    Li-Jung Ma, Tzu-Ju Chen & Chien-Feng Li

  2. Department of Radiation Oncology, Chi-Mei Foundation Medical Center, Liouying, Tainan, Taiwan

    Sung-Wei Lee & Li-Ching Lin

  3. Department of Pathology, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan

    I-Wei Chang

  4. Institute of Medical Education, Chi-Mei Foundation Medical Center, Tainan, Taiwan

    Han-Ping Hsu & Chien-Feng Li

  5. National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan

    Kwang-Yu Chang

  6. Department of Pathology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan

    Hsuan-Ying Huang

  7. Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, Taiwan

    Chien-Feng Li

  8. Graduate Institute of Clinical Medicine, Collage of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

    Chien-Feng Li

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  1. Li-Jung Ma
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Correspondence to Chien-Feng Li.

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Ma, LJ., Lee, SW., Lin, LC. et al. Fibronectin overexpression is associated with latent membrane protein 1 expression and has independent prognostic value for nasopharyngeal carcinoma. Tumor Biol. 35, 1703–1712 (2014). https://doi.org/10.1007/s13277-013-1235-8

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  • DOI: https://doi.org/10.1007/s13277-013-1235-8

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