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Expression of LEF1 and TCF1 (TCF7) proteins associates with clinical progression of nasopharyngeal carcinoma
  1. Yuting Zhan,
  2. Juan Feng,
  3. Junmi Lu,
  4. Lina Xu,
  5. Weiyuan Wang,
  6. Songqing Fan
  1. Department of Pathology, The Second Xiangya Hospital, Central South University, Changsha, China
  1. Correspondence to Dr Songqing Fan, Department of Pathology, The Second Xiangya Hospital, Central South University, Changsha, China; fansongqing2003{at}


Aims Our previous study has demonstrated that β-catenin pathway was abnormally activated in nasopharyngeal carcinoma (NPC). The purposes of the present study are to investigate whether the alterations of LEF1 and TCF1 (TCF7) proteins, the important components of the canonical Wnt/β-catenin pathway, are associated with clinicopathological features and prognostic implications.

Methods We collected 391 cases of NPC, 53 non-cancerous control nasopharyngeal mucosa and 28 pairs of NPC and their matched metastases, detected expression of LEF1 and TCF1 (TCF7) proteins in these tissues by immunohistochemistry. 

Results Results showed that there were significantly increased expression of both LEF1 and TCF1 (TCF7) proteins and coexpression of LEF1 and TCF1 (TCF7) in NPC than these in non-cancerous nasopharyngeal mucosa (all p<0.001), as well as LEF1 and coexpression of LEF1 and TCF1 (TCF7) in matched metastasis NPCs than these in the primary NPCs (p=0.003 and p=0.014, respectively). In addition, expression of LEF1 and the coexpression of LEF1 and TCF1 (TCF7) proteins were positively correlated with lymph node metastasis (p=0.001 and p=0.020, respectively), advanced clinical stage (p<0.003 and p=0.027, respectively) and poor survival status of patients with NPC (p<0.001 and p=0.004, respectively). Moreover, multivariate Cox regression analysis identified that the positive expression of LEF1 was the independent poor prognostic factor for overall survival of patients with NPC (p<0.001).

Conclusions The expression of LEF1 associated positively with TCF1 (TCF7) and clinical progression of NPC, and positive expression of LEF1 protein may act as valuable independent biomarker to predict poor prognosis for patients with NPC.

  • NPC
  • LEF1
  • TCF1 (TCF7)
  • biomarker
  • prognosis

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  • Handling editor Dhirendra Govender.

  • Contributors SF designed and revised the manuscript. YZ wrote the manuscript and drew the figures. JF and YZ made a score for each slide. JL and LX collected the cases. WW participated in the design and revision of the manuscript. All authors read and approved the final version of the review.

  • Funding The work was supported by grants from the National Natural Science Foundation of China (No: 81472773, 81773218, 81703009, 81802791) and the Natural Science Foundation of Hunan Province (No: 2017JJ3457, 2018JJ3858).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. All samples were obtained with informed consent, and all protocols, specimen usage and data retrieval were approved by the Ethics Review Committee of the Second Xiangya Hospital of Central South University (Scientific and Research Ethics Committee, No Y202/2014).

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