Published online Jun 14, 2021. doi: 10.3748/wjg.v27.i22.3085
Peer-review started: October 30, 2020
First decision: January 17, 2021
Revised: January 28, 2021
Accepted: April 25, 2021
Article in press: April 25, 2021
Published online: June 14, 2021
Quinone oxidoreductase 1 (NQO1) plays a cytoprotective role in normal tissues. It is overexpressed in many solid tumors, suggesting a role in cancer development and progression. However, the expression of NQO1 in gastric cancer and its influence on cancer development and prognosis have not been fully addressed.
Identifying molecular markers that can be used as an independent prognostic factor for gastric cancer is of great significance for the early diagnosis and targeted therapy of gastric cancer. The expression of NQO1 in gastric cancer and its influence on clinicopathological characteristics and prognosis have not previously been extensively determined.
The objective of this study was to discover novel effective biomarkers to classify patients with low or high survival. This would provide a guide to clinicians to design personalized therapeutic approaches for gastric cancer patients. In this study, we investigated NQO1 protein, which may determine patient management strategies.
We used IHC to detect the expression of NQO1 in gastric cancer and adjacent tissues. Western blot analysis was performed to detect the expression of NQO1 in gastric cancer cell line. According to IHC scores, the patients were divided into NQO1 high expression group and NQO1 low expression group, and the relationship between the expression level and clinicalpathological data was analyzed.
We found no significant correlations between NQO1 and clinical parameters. However, the follow-up results showed that patients with NQO1 overexpression had a significantly poorer survival rates than those with low levels of NQO1.
Patients with low levels of NQO1 expression showed a poor response to adjuvant chemotherapy and similar survival, compared to those who underwent surgery alone. However, high levels of NQO1 expression indicated a good response to adjuvant chemotherapy and longer overall survival compared with those in patients who underwent surgery alone. In addition, in the Kaplan-Meier analysis, we stratified NQO1 expression based on chemotherapy. The results showed that in patients who underwent surgery only, a significant difference in overall survival was observed, whereas in patients who underwent surgery plus chemotherapy, no difference was found.
This study found that high expression of NQO1 is closely related to a poor prognosis and better response to 5-fluorouracil in patients with gastric cancer.
Our study found prognostic value of NQO1 protein expression in patients with gastric cancer. However, our results need to be validated by independent groups or cohorts in a prospective study.