Background: Sinonasal undifferentiated carcinoma (SNUC) is a rare, highly aggressive cancer that arises in the nasal cavity and paranasal sinuses. Despite aggressive multimodal therapy the prognosis remains poor. To better manage patients with SNUC and help develop therapeutic targets in SNUC, identification of survival predictors is crucial. However, little has been known about survival biomarkers in SNUC.
Materials and Methods: Tumor samples from 29 patients with confirmed diagnosis of SNUC (15 treatment-naive patients and 14 patients who received prior therapy) were used in this study. All the patients were treated at MD Anderson Cancer Center. All the specimens were formalin-fixed and paraffin-embedded tissue. Gene expression analysis was performed on an HTG EdgeSeq Oncology Biomarker Panel with 2,559 oncology-related genes. A univariate Cox regression analysis was performed to determine genes associated with a 5-year overall survival.
Results: First, we identified genes exhibiting a significant prognostic power (p < 0.05) in both treatment naïve patients and patients who received prior therapy. Gene numbers associated with a 5-year overall survival were 58 in the treatment naïve patients and 83 in the treated patients. Of these, FRZB, ER-171, and PFKFB2 showed significant prognostic power in both groups. Then we verified the hazard ratios for each gene in each patient group. By comparing the hazard ratios, we verified that only the PFKFB2 gene, whose protein function is controlling glycolysis and gluconeogenic pathways, showed a consistent correlation between expression levels and vital status; higher expression of PFKFB2 was significantly associated with better survival in both untreated and treated SNUC patients (HR = 0.24, 95% CI: 0.08–0.61, p = 0.0072).
Conclusion: Our study suggests that the levels of PFKFB2 gene might be a potential survival predictor in SNUC patients. To the best of our knowledge, this is the first report of survival biomarker in SNUC. Our result may serve as an important tool to manage patients with SNUC.
