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
Processing time: 220 Days and 21.1 Hours
Abstract
BACKGROUND

Quinine oxidoreductase 1 (NQO1) plays a vital role in protecting normal cells against oxidative damage and electrophilic attack. It is highly expressed in many solid tumors, suggesting a role in cancer development and progression. However, the role of NQO1 in gastric cancer and its effect on cancer development and prognosis have not been fully investigated.

AIM

To investigate the clinical relevance of NQO1 protein expression in gastric cancer and to explore the potential of NQO1 to serve as a prognostic biomarker and therapeutic target.

METHODS

In this retrospective study, gastric cancer specimens of 175 patients who were treated between 1995 and 2011 were subjected to immunohistochemistry analyses for NQO1. The correlation of NQO1 expression with gastric cancer prognosis and clinical and pathological parameters was investigated.

RESULTS

NQO1 protein was overexpressed in 59.43% (104/175) of the analyzed samples. Overexpression of NQO1 was associated with a significantly inferior prognosis. In addition, multivariate analysis suggested that NQO1 overexpression, along with tumor stage and patient age, are prominent prognostic biomarkers for gastric cancer. Moreover, NQO1 overexpression was correlated to a better response to 5-fluorouracil (5-FU)-based adjuvant chemotherapy.

CONCLUSION

NQO1 overexpression is associated with a significantly poor prognosis and better response to 5-FU in patients with gastric cancer. These findings are relevant for improving therapeutic approaches for gastric cancer patients.

Keywords: Gastric cancer; Quinone oxidoreductase 1; Prognosis; Immunohistochemistry; Kaplan-Meier curves; Biomarker

Core Tip: Quinone oxidoreductase 1 may be used as a useful prognostic biomarker and therapeutic target for the efficient management of patients with gastric cancer.