High NANOG expression correlates with worse patients' survival in esophageal adenocarcinoma

• Published in: BMC cancer Vol. 23; no. 1; p. 669
• Main Authors: Knipper, Karl, Damanakis, Alexander I, Lyu, Su Ir, Simon, Adrian Georg, Wahler, Isabell, Bruns, Christiane J, Schröder, Wolfgang, Schmidt, Thomas, Quaas, Alexander
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 17.07.2023; BioMed Central; BMC
• Subjects: Adenocarcinoma; Adjuvant treatment; Age; Analysis; Automation; Biomarkers; Cancer; Cancer therapies; Care and treatment; Diagnosis; Esophageal adenocarcinoma; Esophageal cancer; Esophagus; Gene expression; Genetic aspects; Metastasis; Multimodal therapy; Multivariate analysis; NANOG; Oncology, Experimental; Patient outcomes; Patients; Personalized medicine; Population studies; Prevention; Regression analysis; Risk factors; Stem cells; Surgery; Survival analysis; Transplantation; Tumorigenesis; Tumors; Germany; NANOG; Multimodal therapy; Personalized medicine; Esophageal adenocarcinoma
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-023-11146-0

Patients diagnosed with esophageal cancer demonstrate a low overall survival even despite the established multimodal therapy as the current standard of care. Therefore, further biomarkers for patients with high-risk and additional therapy options are needed. NANOG is a transcription factor, which can be found in stem cells and is known to support tumorigenesis. Six hundred sixty patients with esophageal adenocarcinoma, who were operated at the University of Cologne with a curative intent, were included. Immunohistochemical stainings for NANOG were performed. The study population was divided into NANOG-positive and -negative subgroups. Positive NANOG expression correlates significantly with worse overall survival (p = 0.002) and could be confirmed as an independent risk factor for worse patient survival in multivariate analysis (HR = 1.40, 95%CI = 1.09-1.80, p = 0.006). This effect could be detected in the subgroup of primarily operated patients, but not in patients after neoadjuvant therapy. We describe a NANOG-positive subgroup of patients with esophageal cancer, who exhibit worse overall survival in a large patient cohort. This discovery suggests the potential use of NANOG as a biomarker for both intensified therapy and stricter follow-up regimes. Additionally, NANOG-positive stem cell-like cancer cells could be used as a new antitumoral treatment target if validated in mechanistic and clinical studies.