title: Elevated expression of USP9X correlates with poor prognosis in human non-small cell lung cancer.
abstract: BACKGROUND
  The aim of this study was to investigate the expression of ubiquitin-specific peptidase 9, X-linked (USP9X) in non-small cell lung cancer (NSCLC) patients and to evaluate the relevance of USP9X expression to tumor prognosis.
  
  
  METHODS
  Ninety-five patients who underwent surgical resection for clinical stage I-IIIA NSCLC between July 2008 and July 2011 were included in this study. Immunohistochemical analysis of USP9X expression was performed on 95 NSCLC tissues and 32 adjacent normal lung parenchymal tissues from these patients. The Chi-squared test was used to compare the clinicopathological characteristics between different groups. Kaplan-Meier analysis and a Cox regression model were used to determine the independent prognostic factors. A P value <0.05 was considered to be significant.
  
  
  RESULTS
  The expression of USP9X was found to be significantly higher in NSCLC tissue (44.2%) than in adjacent normal lung parenchymal tissue (6.3%) (P<0.001). High USP9X expression was significantly associated with positive lymph node metastasis (P<0.001), clinical stage (P<0.001) and a reduced overall survival rate (P=0.001) in patients with NSCLC. Based on the multivariate analysis, the elevated expression of the USP9X protein was a significant predictor of poor prognosis for NSCLC patients (HR =2.244, P=0.028).
  
  
  CONCLUSIONS
  The current study demonstrated that the expression of USP9X in NSCLC tissue was significantly higher than that in normal lung tissue and that this elevated expression level of USP9X was associated with poor prognosis among NSCLC patients, suggesting that USP9X might serve as a prognostic biomarker for NSCLC.
authors.affiliation: 1 Department of Radiation and Medical Oncology, 2 Department of Pathology, 3 Hubei Key Laboratory of Tumor Biological Behaviors, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
authors.forename: You
authors.initials: Y
authors.lastname: Wang
authors.affiliation: 1 Department of Radiation and Medical Oncology, 2 Department of Pathology, 3 Hubei Key Laboratory of Tumor Biological Behaviors, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Liu
authors.affiliation: 1 Department of Radiation and Medical Oncology, 2 Department of Pathology, 3 Hubei Key Laboratory of Tumor Biological Behaviors, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Yang
authors.affiliation: 1 Department of Radiation and Medical Oncology, 2 Department of Pathology, 3 Hubei Key Laboratory of Tumor Biological Behaviors, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Cao
authors.affiliation: 1 Department of Radiation and Medical Oncology, 2 Department of Pathology, 3 Hubei Key Laboratory of Tumor Biological Behaviors, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
authors.forename: Chun-Xu
authors.initials: CX
authors.lastname: Yang
authors.affiliation: 1 Department of Radiation and Medical Oncology, 2 Department of Pathology, 3 Hubei Key Laboratory of Tumor Biological Behaviors, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Ouyang
authors.affiliation: 1 Department of Radiation and Medical Oncology, 2 Department of Pathology, 3 Hubei Key Laboratory of Tumor Biological Behaviors, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
authors.forename: Shi-Min
authors.initials: SM
authors.lastname: Zhang
authors.affiliation: 1 Department of Radiation and Medical Oncology, 2 Department of Pathology, 3 Hubei Key Laboratory of Tumor Biological Behaviors, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
authors.forename: Gui-Fang
authors.initials: GF
authors.lastname: Yang
authors.affiliation: 1 Department of Radiation and Medical Oncology, 2 Department of Pathology, 3 Hubei Key Laboratory of Tumor Biological Behaviors, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
authors.forename: Fu-Xiang
authors.initials: FX
authors.lastname: Zhou
authors.affiliation: 1 Department of Radiation and Medical Oncology, 2 Department of Pathology, 3 Hubei Key Laboratory of Tumor Biological Behaviors, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
authors.forename: Yun-Feng
authors.initials: YF
authors.lastname: Zhou
authors.affiliation: 1 Department of Radiation and Medical Oncology, 2 Department of Pathology, 3 Hubei Key Laboratory of Tumor Biological Behaviors, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
authors.forename: Cong-Hua
authors.initials: CH
authors.lastname: Xie
keywords: Ubiquitin-specific peptidase 9, X-linked (USP9X); immunohistochemistry; non-small cell lung cancer (NSCLC); prognosis