Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 14, 2021; 27(22): 3085-3096
Published online Jun 14, 2021. doi: 10.3748/wjg.v27.i22.3085
Quinone oxidoreductase 1 is overexpressed in gastric cancer and associated with outcome of adjuvant chemotherapy and survival
Zhi-Nong Jiang, Syed Minhaj Uddin Ahmed, Qin-Chuan Wang, Hong-Fei Shi, Xiu-Wen Tang
Zhi-Nong Jiang, Department of Pathology, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang Province, China
Syed Minhaj Uddin Ahmed, Xiu-Wen Tang, Department of Biochemistry, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang Province, China
Syed Minhaj Uddin Ahmed, Xiu-Wen Tang, Department of Thoracic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Qin-Chuan Wang, Department of Surgical Oncology, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang Province, China
Hong-Fei Shi, Department of Pathology, The Forth Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 322000, Zhejiang Province, China
Author contributions: Tang XW and Jiang ZN conceived the study; Ahmed SMU performed the experiments; Jiang ZN, Wang QC, Ahmed SM, Shi H, and Tang XW analyzed the data; Ahmed SM and Tang XW wrote the manuscript; all authors have read and approved the final manuscript; Jiang ZN and Ahmed SM contributed equally to this work.
Supported by the National Natural Science Foundation of China, No. 31971188 and No. 81773189; the Nature Science Foundation of Zhejiang Province, China, No. LQ16H160004 and No.LY17H270002; and The Hygiene Department of Zhejiang, No. 2016KYB139.
Institutional review board statement: The study was reviewed and approved by the Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine Institutional Review Board [(Approval No. 20200917-32)].
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study.
Conflict-of-interest statement: The authors declare that they have no competing interests to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiu-Wen Tang, PhD, Full Professor, Department of Biochemistry and Department of Thoracic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 17 Lao Zhe-da Road, Hangzhou 310003, Zhejiang Province, China. xiuwentang@zju.edu.cn
Received: October 30, 2020
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
ARTICLE HIGHLIGHTS
Research background

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.

Research motivation

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.

Research objectives

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.

Research methods

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.

Research results

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.

Research conclusions

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.

Research perspectives

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.