title: Decreased mRNA expression of transcription factor forkhead box F2 is an indicator of poor prognosis in patients with resected esophageal squamous cell carcinoma.
abstract: The transcription factor forkhead box F2 (FOXF2) is an evolutionarily conserved DNA-binding protein involved in embryogenesis and metabolism. Although recent studies prove that FOXF2 is a tumor suppressor in various human cancers, the role of FOXF2 in esophageal squamous cell carcinoma (ESCC) remains unknown. Therefore, samples were collected from 188 ESCC patients, including 33 pairs of tumor and non-tumor tissues, andFOXF2mRNA expression was investigated by quantitative polymerase chain reaction. The results demonstrated thatFOXF2mRNA is downregulated in tumor tissues compared to paired non-tumor tissues (P=0.048). The receiver operating characteristic curve analysis indicated 1.2 as a cut-off point and, thus, 125 and 63 tumors were classified as low- and high-levelFOXF2mRNA expression, respectively. We observed that low-levelFOXF2mRNA expression in the tumors was associated with a higher frequency of lymph node metastasis (P=0.044), an effect further suggested by the multivariate logistic regression analysis (P=0.060). According to the univariate Cox analysis, patients harboring tumors with low-levelFOXF2mRNA expression had a significantly increased mortality risk compared to those with high-level expression (hazard ratio=1.700, 95% confidence interval, 1.077-2.681), with 5-year survival rates of 41.1 and 61.9%, respectively. This negative prognostic effect of low-levelFOXF2mRNA expression was further validated in the multivariate Cox analysis (P=0.021). The subgroup analysis demonstrated that the effect ofFOX2mRNA expression was limited to male patients and those with advanced-stage disease. Taken together, these findings suggest thatFOXF2may be an anti-oncogene for ESCC and decreasedFOXF2mRNA expression is associated with a poor prognosis in patients with ESCC.
authors.affiliation: Department of Thoracic Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong 510060, P.R. China ; Guangdong Esophageal Cancer Institute, Guangzhou, Guangdong 510060, P.R. China.
authors.forename: Yu-Zhen
authors.initials: YZ
authors.lastname: Zheng
authors.affiliation: Guangdong Esophageal Cancer Institute, Guangzhou, Guangdong 510060, P.R. China ; Department of Experimental Research, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong 510060, P.R. China.
authors.forename: Jing
authors.initials: J
authors.lastname: Wen
authors.affiliation: Guangdong Esophageal Cancer Institute, Guangzhou, Guangdong 510060, P.R. China ; Intensive Care Unit, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong 510060, P.R. China.
authors.forename: Xun
authors.initials: X
authors.lastname: Cao
authors.affiliation: Department of Thoracic Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong 510060, P.R. China ; Guangdong Esophageal Cancer Institute, Guangzhou, Guangdong 510060, P.R. China.
authors.forename: Hong
authors.initials: H
authors.lastname: Yang
authors.affiliation: Department of Thoracic Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong 510060, P.R. China ; Guangdong Esophageal Cancer Institute, Guangzhou, Guangdong 510060, P.R. China.
authors.forename: Kong-Jia
authors.initials: KJ
authors.lastname: Luo
authors.affiliation: Department of Thoracic Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong 510060, P.R. China ; Guangdong Esophageal Cancer Institute, Guangzhou, Guangdong 510060, P.R. China.
authors.forename: Qian-Wen
authors.initials: QW
authors.lastname: Liu
authors.affiliation: Department of Thoracic Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong 510060, P.R. China ; Guangdong Esophageal Cancer Institute, Guangzhou, Guangdong 510060, P.R. China.
authors.forename: Qing-Yuan
authors.initials: QY
authors.lastname: Huang
authors.affiliation: Department of Thoracic Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong 510060, P.R. China ; Guangdong Esophageal Cancer Institute, Guangzhou, Guangdong 510060, P.R. China.
authors.forename: Jun-Ying
authors.initials: JY
authors.lastname: Chen
authors.affiliation: Department of Thoracic Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong 510060, P.R. China ; Guangdong Esophageal Cancer Institute, Guangzhou, Guangdong 510060, P.R. China.
authors.forename: Jian-Hua
authors.initials: JH
authors.lastname: Fu
keywords: biomarker; esophageal cancer; gene expression; outcomes; transcription factor forkhead box F2