title: High expression of Zinc-finger protein X-linked is associated with reduced E-cadherin expression and unfavorable prognosis in nasopharyngeal carcinoma.
abstract: Zinc-finger protein X-linked (ZFX), a novel transcription factor required for self-renewal of embryonic stem cells, has recently been implicated in the initiation and progression of various human malignancies. However, its clinical significance in cancer patients remains largely inconclusive and its role in nasopharyngeal carcinoma (NPC) has never been reported. In this study, quantitative real-time polymerase chain reaction, Western blot and Immunohistochemistry were performed to detect ZFX expression in NPC and normal nasopharyngeal tissues. As a result, we found ZFX expression was significantly elevated in NPC tissues compared with that in normal nasopharyngeal tissues. The statistical analysis based on immunohistochemical staining demonstrated that ZFX expression was significantly correlated with lymph node stage and clinical stage. Furthermore, we found NPC patients with high ZFX expression had lower 5-year overall survival rates, progression-free survival rates, loco-regional relapse-free survival rates and distant metastasis-free survival rates than those with low ZFX expression (all P<0.05). The multivariate analysis indicated that ZFX expression was an independent prognostic factor for patients with NPC. More importantly, we also detected E-cadherin expression in NPC tissues and found it was inversely correlated with ZFX expression in NPC tissues, suggesting a potential involvement of ZFX in Epithelial-mesenchymal transition (EMT). Therefore, it is speculated that ZFX may promote NPC progression partly by regulating EMT. In summary, our study not only for the first time identified that ZFX could serve as an effective prognostic biomarker for NPC patients, but also suggested that targeting ZFX might be a novel therapeutic strategy for preventing NPC progression and metastasis.
authors.affiliation: Department of Otorhinolaryngology, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University 600 Yi-Shan Road, Shanghai 200233, China.
authors.forename: Yin
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Medicine, Soochow University 1 Shi-Zi Road, Suzhou 215006, China ; Department of General Surgery, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University 600 Yi-Shan Road, Shanghai 200233, China.
authors.forename: Xuebing
authors.initials: X
authors.lastname: Yan
authors.affiliation: Department of Medicine, Soochow University 1 Shi-Zi Road, Suzhou 215006, China.
authors.forename: Leilei
authors.initials: L
authors.lastname: Yan
authors.affiliation: Department of General Surgery, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University 600 Yi-Shan Road, Shanghai 200233, China.
authors.forename: Zezhi
authors.initials: Z
authors.lastname: Shan
authors.affiliation: Department of Medicine, Soochow University 1 Shi-Zi Road, Suzhou 215006, China.
authors.forename: Sihong
authors.initials: S
authors.lastname: Liu
authors.affiliation: Department of Otorhinolaryngology, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University 600 Yi-Shan Road, Shanghai 200233, China.
authors.forename: Xiaojuan
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Otorhinolaryngology, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University 600 Yi-Shan Road, Shanghai 200233, China.
authors.forename: Jianyin
authors.initials: J
authors.lastname: Zou
authors.affiliation: Department of Otorhinolaryngology, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University 600 Yi-Shan Road, Shanghai 200233, China.
authors.forename: Weitian
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University 600 Yi-Shan Road, Shanghai 200233, China.
authors.forename: Zhiming
authors.initials: Z
authors.lastname: Jin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015820:Cadherins / Q000235:genetics / Q000378:metabolism*; D002277:Carcinoma / Q000235:genetics / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D018572:Disease-Free Survival; D015536:Down-Regulation; D005260:Female; D006801:Humans; D051741:Kruppel-Like Transcription Factors / Q000235:genetics / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000235:genetics / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D011379:Prognosis; D015996:Survival Rate; D055815:Young Adult
chemical_list: D015820:Cadherins; D051741:Kruppel-Like Transcription Factors; C062076:zinc finger protein, X-linked
keywords: E-cadherin; ZFX; nasopharyngeal carcinoma; prognosis