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Expression of cyclin-dependent kinase 2-associated protein 1 confers an independent prognosticator in nasopharyngeal carcinoma: a cohort study
  1. Li-Ching Wu1,2,
  2. Yi-Ling Chen3,
  3. Wen-Ren Wu3,
  4. Chien-Feng Li1,3,4,
  5. Hsuan-Ying Huang5,
  6. Sung-Wei Lee6,
  7. Shih-Lun Chang7,
  8. Ching-Yih Lin8,
  9. Yi-Hsien Chen9,
  10. Han-Ping Hsu10,
  11. Pei-Jung Lu11,
  12. Yow-Ling Shiue2,12
  1. 1Department of Pathology, Chi-Mei Medical Center, Tainan, Taiwan
  2. 2Department of Medi University, Chung Hwa University of Medical Technology, Tainan, Taiwan
  3. 3Institute of Biomedical Science, National Sun Yat-sen University, Kaohsiung, Taiwan
  4. 4National Institute of Cancer Research, National Health Heath Research Institute, Tainan, Taiwan
  5. 5Department of Pathology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, College of Medicine, Chang Gung University, Kaohsiung, Taiwan
  6. 6Department of Radiation Oncology, Chi-Mei Medical Center, Liouying, Tainan, Taiwan
  7. 7Department of Otolaryngology, Chi-Mei Medical Center, Tainan, Taiwan
  8. 8Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chi-Mei Medical Center, Tainan, Taiwan
  9. 9Emergency Department, Chi-Mei Medical Center, Tainan, Yungkang, Taiwan
  10. 10College of Medicine, China Medical University, Taichung, Taiwan
  11. 11Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan
  12. 12Department of Biological Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
  1. Correspondence to Dr Yow-Ling Shiue, Institute of Biomedical Science, National Sun Yat-sen University, 70, Lien-hai Rd, Kaohsiung 80424, Taiwan; ylshiue{at}


Background and aim Low expression of cyclin-dependent kinase 2-associated protein (CDK2AP1) is associated with tumour progression in oral and oesophageal carcinomas, but is not well studied in patients with head and neck cancer and nasopharyngeal carcinoma (NPC).

Methods A rabbit anti-human CDK2AP1 polyclonal antibody was prepared. Immunoblotting of CDK2AP1 was examined in three cell lines and immunoexpression was retrospectively assessed in biopsies of 124 consecutive NPC patients without initial distant metastasis and treated with consistent guidelines.

Results Higher CDK2AP1 expression level was identified in dysplastic oral keratinocytes, compared with two NPC-derived HONE-1 and TW01 cell lines. Low expression of CDK2AP1 (50.8%) was correlated with advanced nodal status (p=0.002) and American Joint Committee on Cancer (AJCC) stage (p=0.004). In multivariate analyses, low CDK2AP1 expression emerged as an independent prognosticator for worse disease-specific survival (DSS; p=0.037) and local recurrence-free survival (LRFS; p=0.042), along with AJCC stage III–IV (p=0.034, DSS; p=0.029, LRFS).

Conclusions Low CDK2AP1 expression is common and associated with adverse prognosticators, conferring tumour aggressiveness through cycle cycle, cell growth or apoptosis cellular processes.

  • Nasopharyngeal carcinoma
  • cyclin-dependent kinase 2-associated protein 1
  • survival
  • diagnosis
  • cancer research
  • cell biology
  • cancer
  • oncogenes
  • molecular oncology
  • molecular pathology
  • molecular genetics
  • gastric cancer
  • gastritis
  • gastroenterology
  • liver cancer
  • fertility
  • genetics

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  • Funding This work was supported by grants DOH99-TD-C-111-004 (Department of Health, Taiwan) to CF Li and 98-2311-B-110-001-MY3 (National Science Council, Taiwan) to YL Shiue.

  • Competing interests None.

  • Ethics approval Ethics approval was provided by Chi-Mei Medical Center, Tainan, Taiwan.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The original immunostaining and statistical data are available from the corresponding author at ylshiue{at}