Abstract
Background: Current biomarkers for nasopharyngeal carcinoma (NPC) are less effective for early diagnosis and prognosis. The basic leucine zipper ATF-like transcription factor 2 (BATF2) gene has been shown to have a tight association with the pathogenesis of various malignancies but received scant attention in NPC research. We aimed to assess the performances of circulating and tissue BATF2 in the diagnosis and prognosis of NPC. Materials and Methods: Immunohistochemistry (IHC) microarrays were performed to quantitate the BATF2 protein expression in NPC tissues. The relationships of BATF2 protein expression with clinicopathological characteristics and NPC prognosis were assessed. BATF2 mRNA expressions in serum and serum-derived exosomes were determined using quantitative reverse transcription-polymerase chain reaction (qRT-PCR) assay. Results: The IHC microarrays revealed a predominant nuclear expression of BATF2 in NPC cells. The Kaplan-Meier survival analysis showed that BATF2-positive NPC patients enjoyed longer overall survival than BATF2-negative patients. NPC patients with serum and exosomal BATF2 mRNA expressions made up 51.47 and 48.52% of all patients, respectively. The AUCs of serum and exosomal BATF2 mRNA expressions in discriminating NPC from healthy controls were 0.9409 and 0.8983. Patients who had received radiochemotherapy exhibited higher serum and exosomal BATF2 mRNA expressions versus the levels at baseline as well as those detected in recurrent patients. Conclusion: BATF2 is expressed cancerous tissues, serum, and serum-derived exosomes in NPC patients. Circulating and tissue BATF2 can serve as a multipurpose biomarker capable of the diagnosis, prognosis prediction, efficacy evaluation, and recurrence monitoring in NPC.
Highlights
Nasopharyngeal carcinoma (NPC) is a head and neck malignancy originating from nasopharyngeal mucosa (Lee et al, 2019), with an incidence rate of 20–30 per 100 000 people/year (Li et al, 2011)
We found that serum basic leucine zipper ATF-like transcription factor 2 (BATF2) suppression had a strong association with squamous cell carcinoma antigen (SCC-Ag) levels (Figure 3A), without significant correlations with CEA, CYFRA21-1, or EBV-DNA levels (Figures 3B–D, all p > 0.05)
We found that serum BATF2 mRNA expression was positively associated with SCC-Ag levels, which indicates its diagnostic potential in NPC
Summary
Nasopharyngeal carcinoma (NPC) is a head and neck malignancy originating from nasopharyngeal mucosa (Lee et al, 2019), with an incidence rate of 20–30 per 100 000 people/year (Li et al, 2011). The latest epidemiological report of NPC in China showed that the high-risk areas of NPC, where the incidence and mortality remained high in recent years, Significance of BATF2 in NPC mainly included Guangdong, Guangxi, Hunan, Fujian, and Jiangxi provinces and Hong Kong (Li et al, 2011; Trejaut et al, 2011). The failure of early diagnosis due to concealed nasopharyngeal anatomy and atypical symptoms of early NPC remains a significant clinical concern (Ng et al, 2011). Current biomarkers for nasopharyngeal carcinoma (NPC) are less effective for early diagnosis and prognosis. We aimed to assess the performances of circulating and tissue BATF2 in the diagnosis and prognosis of NPC
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