Periostin overexpression is associated with worse prognosis in nasopharyngeal carcinoma from endemic area: a cohort study
Received 24 January 2018
Accepted for publication 11 April 2018
Published 29 May 2018 Volume 2018:11 Pages 3205—3213
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 3
Editor who approved publication: Dr Ingrid Espinoza
Yu-Ching Wei,1,2 Sheau-Fang Yang,2,3 Shih-Lun Chang,4,5 Tzu-Ju Chen,5,6 Sung-Wei Lee,7 Hung-Sung Chen,1 Li-Ching Lin,8 Chien-Feng Li6,9,10
1Department of Pathology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan; 2Department of Pathology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; 3Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; 4Department of Otolaryngology, Chi Mei Medical Center, Tainan, Taiwan; 5Department of Optometry, Chung Hwa University of Medical Technology, Tainan, Taiwan; 6Department of Pathology, Chi Mei Medical Center, Tainan, Taiwan; 7Department of Radiation Oncology, Chi Mei Medical Center, Liouying, Tainan, Taiwan; 8Department of Radiation Oncology, Chi Mei Medical Center, Tainan, Taiwan; 9National Institute of Cancer Research, National Health Research Institute, Tainan, Taiwan; 10Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, Taiwan
Purpose: Nasopharyngeal carcinoma (NPC) is a heterogeneous disease. We searched for genes that function in cell adhesion in GSE12452, a published transcriptomic database. We found that POSTN, which encodes periostin (POSTN), was significantly upregulated in NPC tumorigenesis. Herein, we sought to analyze the expression of POSTN and its prognostic significances in patients with NPC.
Materials and methods: In this single-institution retrospective study, we determined and analyzed POSTN expression by immunohistochemistry and H-score method, respectively, in 124 patients with NPC. The results indicated that POSTN expression was correlated with the clinicopathologic features, disease-specific survival (DSS), distant metastasis-free survival (DMFS), and local recurrence-free survival (LRFS) of NPC. We performed univariate and multivariate analyses to determinate the statistical significance.
Results: High POSTN expression was significantly associated with lymph node metastasis (p=0.004) and advanced American Joint Committee on Cancer (AJCC) stage (p=0.006). In univariate analysis, high POSTN expression served as a significant prognostic factor for worse DSS (p=0.0002), DMFS (p=0.0138), and LRFS (p=0.0028). In multivariate Cox regression analyses, which was adjusted for AJCC stages, POSTN expression was independently associated with cancer-related death (HR: 2.311; 95% CI: 1.327–4.027; p=0.003) and local tumor recurrence (HR: 3.187; 95% CI: 1.108–4.408; p=0.024).
Conclusion: High POSTN expression is associated with tumor aggressiveness and worse clinical outcomes in NPC, indicating that it may be a potential prognostic biomarker and a therapeutic target.
Keywords: nasopharyngeal cancer, periostin, oncologic, outcomes
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