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Zinc finger AN1-type containing 4 is a novel marker for predicting metastasis and poor prognosis in oral squamous cell carcinoma
  1. Miyako Kurihara-Shimomura1,
  2. Tomonori Sasahira2,
  3. Hiroshi Nakamura1,
  4. Chie Nakashima1,
  5. Hiroki Kuniyasu2,
  6. Tadaaki Kirita1
  1. 1 Department of Oral and Maxillofacial Surgery, Nara Medical University, Kashihara, Japan
  2. 2 Department of Molecular Pathology, Nara Medical University, Kashihara, Japan
  1. Correspondence to Dr Tomonori Sasahira, Department of Molecular Pathology, Nara Medical University, Kashihara 634-8521, Japan; sasa{at}


Aims Head and neck cancer, including oral squamous cell carcinoma (OSCC), is the sixth most common cancer worldwide and has a high potential for locoregional invasion and nodal metastasis. Therefore, discovery of a useful molecular biomarker capable of predicting tumour progression and metastasis of OSCC is crucial. We have previously reported zinc finger AN1-type containing 4 (ZFAND4) as one of the most upregulated genes in recurrent OSCC using a cDNA microarray analysis. Although ZFAND4 has been shown to promote cell proliferation of gastric cancer, its expression and clinicopathological roles in OSCC remain unclear.

Methods In this study, we examined ZFAND4 expression by immunohistochemistry in 214 cases of OSCC.

Results High cytoplasmic expression of ZFAND4 was observed in 45 out of 214 (21%) patients with OSCC. Expression levels of ZFAND4 were strongly associated with metastasis to the lymph nodes (p=0.0429) and distant organs (p=0.0068). Cases with high expression of ZFAND4 had a significantly unfavourable prognosis compared with patients with low expression of ZFAND4 (p<0.0001). Furthermore, ZFAND4 overexpression was an independent poor prognostic factor for OSCC as determined by multivariate analysis using the Cox proportional hazards model (p<0.0001).

Conclusions These results suggest that ZFAND4 is a useful marker for predicting metastasis and poor prognosis in patients with OSCC.

  • ZFAND4
  • metastasis
  • prognosis
  • oral cancer

Statistics from


  • MK-S and TS contributed equally.

  • Handling editor Runjan Chetty.

  • Contributors Conception and design: TS, HK. Acquisition of data: TS, MKS, HN, CN. Analysis and interpretation of data: TS, MKS, CN, TK. Writing and review of the manuscript: TS, MKS, HK, TK.

  • Disclaimer This abstract has been translated and adapted from the original English-language content. Translated content is provided on an ‘as is’ basis. Translation accuracy or reliability is not guaranteed or implied. BMJ is not responsible for any errors and omissions arising from translation to the fullest extent permitted by law, BMJ shall not incur any liability, including without limitation, liability for damages, arising from the translated text.

  • Competing interests We declare that there is not any financial support or relationships which may pose a conflict of interest in the contents of the submitted manuscript.

  • Patient consent Obtained.

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

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