International Journal of Medical Sciences

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21 November 2018

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Int J Med Sci 2018; 15(10):992-998. doi:10.7150/ijms.25065

Research Paper

CDKN3 expression is an independent prognostic factor and associated with advanced tumor stage in nasopharyngeal carcinoma

Shih-Lun Chang1,2, Tzu-Ju Chen2,3, Ying-En Lee4, Sung-Wei Lee5, Li-Ching Lin6, Hong-Lin He3,✉

1. Department of Otolaryngology, Chi Mei Medical Center, Tainan, Taiwan
2. Department of Optometry, Chung Hwa University of Medical Technology, Tainan, Taiwan
3. Department of Pathology, Chi-Mei Medical Center, Tainan, Taiwan
4. Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
5. Department of Radiation Oncology, Chi Mei Medical Center, Liouying, Tainan, Taiwan
6. Department of Radiation Oncology, Chi Mei Medical Center, Tainan, Taiwan

Abstract

Background: Through data mining from the public transcriptome of NPC, cyclin-dependent kinase inhibitor 3 (CDKN3) was identified as a significantly upregulated gene in NPC. CDKN3 functions as a key factor in cell cycle regulation. This study was aimed to investigate the expression of CDKN3 in NPC tissues and its prognostic significance.

Methods: Immunohistochemistry was performed for 124 NPC patients to assess the protein expression of CDKN3. The stainings of CDKN3 were scored by using H-score method. The relationships between CDKN3 expression status and clinicopathological parameters, disease-specific survival (DSS), distant metastasis-free survival (DMeFS), and local recurrence-free survival (LRFS) were statistically analyzed.

Results: High expression of CDKN3 was significantly associated with higher primary nodal status (P=0.030) and higher TNM stage (P=0.019). In univariate analysis, high expression of CDKN3 predicted worse DSS (P<0.0001), DMeFS (P<0.0001), and LRFS (P<0.0001). In multivariate analysis, CDKN3 overexpression still acted as an independent prognostic factor for worse DSS (P<0.001; hazard ratio [HR]=11.999, 95% CI: 5.378-26.771), DMeFS (P<0.001; HR=15.069, 95% CI: 5.884-38.592), and LRFS (P<0.001; HR=5.000, 95% CI: 2.312-10.815).

Conclusion: High expression of CDKN3 was an independent negative prognostic factor for NPC and was associated with advanced disease status. It might serve as potential therapeutic target and aid in risk stratification for patients with NPC.

Keywords: CDKN3, nasopharyngeal carcinoma, NPC, cell cycle, transcriptome

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How to cite this article:
Chang SL, Chen TJ, Lee YE, Lee SW, Lin LC, He HL. CDKN3 expression is an independent prognostic factor and associated with advanced tumor stage in nasopharyngeal carcinoma. Int J Med Sci 2018; 15(10):992-998. doi:10.7150/ijms.25065. Available from http://www.medsci.org/v15p0992.htm