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

BACKGROUND: Homeobox A9 (HOXA9), a member of the HOX protein family, plays diverse biological roles in embryonic development and carcinogenesis. The prognostic value of HOXA9 expression in nasopharyngeal carcinoma (NPC) is not well-defined. The present study aimed to analyse NPC tissue HOXA9 expression and determine prognostic significance by investigating the relationship between HOXA9 expression and clinicopathologic features. METHODS: Between January 2010 and December 2014, 252 NPC patients and 30 chronic nasopharyngitis patients (control group) were recruited to participate in the present study. Correlations between HOXA9 expression level and clinicopathologic features (including survival) were analysed. RESULTS: High HOXA9 expression was significantly associated with clinical stage (p < 0.01) and higher T stage (p < 0.01). In univariate analysis, high HOXA9 expression predicted overall survival (OS) (p = 0.011). In multivariate analysis, HOXA9 over-expression independently and significantly predicted poorer PFS (p < 0.01, hazard ratio (HR) = 2.387, 95% CI [0.876, 6.545]) and OS (p < 0.01, HR = 2.486, 95% CI [1.041, 8.926]). CONCLUSION: High HOXA9 expression is an independent prognostic factor associated with advanced tumour stage and poorer survival in NPC patients.