HOXA9 Expression is Associated with Advanced Tumour Stage and Prognosis in Nasopharyngeal Carcinoma

Figures & data

Table 1 Patients Demographics and Disease Characteristics

Characteristics		N=252
		Cases	Percentage (%)
Age (years)
	Median	51
	Range	22–78
	≤50	132	52.4
	>50	120	47.6
Gender
	Male	183	72.6
	Female	69	27.4
Histological grade
	Keratinizing +Non-keratinizing	53	21.0
	Undifferentiated	199	79.0
Primary tumor (T)
	T1+T2	105	41.7
	T3+T4	147	58.3
Nodule status (N)
	N0+N1	89	35.3
	N2+N3	163	64.7
Stage
	II	37	14.6
	III	119	47.2
	IVa	60	23.8
	IVb	36	14.3
Treatment	Radiotherapy+Chemotherapy	240	95.2
	Radiotherapy	12	4.8
Patient status
	Tumor relapse	31	12.3
	Metastasis	75	29.8
	Overall survival	156	62.0
	Disease free survival	114	45.3
	Death	96	38.1

Table 2 The Relationship Between the Expression of HOXA9 and Clinical Pathological Characteristics of Nasopharyngeal Carcinoma

Parameters	No. of Case	Average Opticle (×10^−3)	High Expression	Low Expression	χ2	P value
Gender					1.13	0.286
Male	183	4.96 (0.27–21.24)	96	87
Female	69	3.24 (1.12–18.70)	31	38
Age (years)					0.79	0.374
≤50	132	4.79 (1.26–21.24)	63	69
>50	120	4.62 (0.27–20.70)	64	56
Histological grade					0.16	0.690
Keratinizing +Non-keratinizing	53	4.34 (0.27–19.87)	28	25
Undifferentiated	199	4.15 (0.33–21.24)	99	100
Primary tumor (T)					79.62	<0.01*
T1+T2	105	2.69 (0.27–21.24)	18	87
T3+T4	147	6.72 (0.98–21.05)	109	38
Nodule status (N)					3.549	0.060
N0+N1	89	3.48 (0.27–13.80)	52	37
N2+N3	163	4.78 (0.35–21.24)	75	88
Stage					36.08	<0.01*
II	37	1.48 (0.27–7.89)	6	31
III	119	3.38 (0.58–17.89)	53	66
IVa	60	7.24 (1.78–15.87)	45	15
IVb	36	10.76 (4.78–21.24)	23	13

Note: *Statistically significant.

Table 3 Expression of HOXA9 in Nasopharyngeal Carcinoma and Chronic Nasopharyngitis

Group	No. of Case	Average Opticle (×10^−3)	High Expression	Low Expression	P value
NPC group	252	4.98(0.27–21.24)	127	125	0.001*
Chronic nasopharyngitis	30	0.98(0.18–6.74)	1	29

Note: *Statistically significant.

Figure 1 Immunohistochemical staining for expression of HOXA9 in nasopharyngeal carcinoma (NPC) and mucosal tissue of chronic nasopharyngitis (SP×400). (A) low HOXA9 expression in mucosal tissue of chronic nasopharyngitis. (B) low HOXA9 expression in NPC tissue. (C) high HOXA9 expression in NPC tissue.

Table 4 Correlation of HOXA9 Expression in Nasopharyngeal Carcinoma with EB Virus Infection

EBV-Serology	No. of Cases	HOXA9 Expression		χ2	P value
		High	Low
Positive	98	51	47	0.191	0.662
Negative	80	39	41

Figure 2 Kaplan-Meier survival curves for nasopharyngeal carcinoma patients exhibiting low versus high HOXA9 expression. (A) Progress free survival. (B) Overall survival. P value were obtained using the Log rank test.

Table 5 Cox Risk Regression Model for Single Factor Analysis of Factors Affecting the Prognosis of Patients with Nasopharyngeal Carcinoma

Parameters	HR (95% CI)	P value
Gender (Female vs Male)	1.36 (0.91–2.03)	0.511
Age (>50 years vs ≤50 years)	2.34 (0.89–6.19)	0.135
Histological grade (Keratinizing+Non-keratinizing vs Undifferentiated)	1.16 (0.49–2.71)	0.143
Primary tumor (T1+T2 vs T3+T4)	7.63 (2.83–20.57)	0.013*
Nodule status (N0+N1 vs N2+N3)	2.52 (0.91–7.02)	0.083
Stage (II vs III+IV)	1.12 (0.42–3.02)	0.432
HOXA9 expression (High vs Low)	2.30 (1.06–4.99)	0.011*

Note: *Statistically significant.

Abbreviations: HR, hazard ratio; CI, confidence interval.

Table 6 Cox Risk Regression Model for Multivariate Survival Analysis of Factors Affecting the Prognosis of Patients with Nasopharyngeal Carcinoma

Parameter	Category	PFS			OS
		HR	95% CI	P value	HR	95% CI	P value
Primary tumor(T)	T1-T2	1	-		1	-
	T3-T4	1.838	0.978–3.543	0.022*	2.732	0.967–6.202	0.032*
HOXA9 expression	Low expression	1	-		1	-
	High expression	2.387	0.876–6.545	<0.01*	2.486	1.041–8.926	<0.01*

Notes: *Statistically significant.

Abbreviations: HR, hazard ratio; CI, confidence interval; PFS, progression free survival; OS, overall survival.