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The<jats:italic>BCL2<\/jats:italic>-<jats:italic>associated X<\/jats:italic>(<jats:italic>BAX<\/jats:italic>) gene encodes the most important pro-apoptotic member of the BCL2 family. We have recently shown that<jats:italic>BCL2<\/jats:italic>and<jats:italic>BCL2L12<\/jats:italic>, two other members of the same apoptosis-related family, possess significant prognostic value in NPC. The objective of the current study was to analyze<jats:italic>BAX<\/jats:italic>mRNA expression in nasopharyngeal biopsies of NPC patients, and to assess its prognostic potential in this disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Total RNA was isolated from 88 malignant and 9 hyperplastic nasopharyngeal biopsies, resected from Tunisian patients. After cDNA synthesis by reverse transcription of polyadenylated RNA,<jats:italic>BAX<\/jats:italic>mRNA expression was analyzed using a highly sensitive quantitative real-time polymerase chain reaction (qRT-PCR) method.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Lower<jats:italic>BAX<\/jats:italic>mRNA levels were detected in NPC biopsies than in hyperplastic nasopharyngeal samples.<jats:italic>BAX<\/jats:italic>mRNA expression status was associated with low tumor extent, negative regional lymph node status, and absence of distant metastases. Kaplan-Meier survival analysis demonstrated that patients with<jats:italic>BAX<\/jats:italic>mRNA-positive NPC have significantly longer disease-free survival (DFS) and overall survival (OS). In accordance with these findings, Cox regression analysis revealed that<jats:italic>BAX<\/jats:italic>mRNA expression can be considered as a favorable prognostic indicator of DFS and OS in NPC, independent of their gender, age, tumor histology, tumor extent, and nodal status. Furthermore, NPC patients without distant metastases are less likely to relapse when their primary tumor is<jats:italic>BAX<\/jats:italic>mRNA-positive, compared to metastasis-free patients with a<jats:italic>BAX<\/jats:italic>-negative nasopharyngeal malignancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This is the first study examining the potential clinical utility of<jats:italic>BAX<\/jats:italic>as a prognostic tumor biomarker in NPC. We provide evidence that<jats:italic>BAX<\/jats:italic>mRNA expression can be considered as an independent favorable prognostic indicator of DFS and OS in NPC.<\/jats:p><\/jats:sec>","DOI":"10.1186\/1471-2407-13-293","type":"journal-article","created":{"date-parts":[[2013,6,18]],"date-time":"2013-06-18T12:45:45Z","timestamp":1371559545000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Quantitative expression analysis and prognostic significance of the BCL2-associated Xgene in nasopharyngeal carcinoma: a retrospective cohort study"],"prefix":"10.1186","volume":"13","author":[{"given":"Christos K","family":"Kontos","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Fendri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdelmajid","family":"Khabir","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raja","family":"Mokdad-Gargouri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Scorilas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2013,6,18]]},"reference":[{"issue":"4","key":"3924_CR1","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1038\/bjc.1972.33","volume":"26","author":"JF Kerr","year":"1972","unstructured":"Kerr JF, Wyllie AH, Currie AR: Apoptosis: a basic biological phenomenon with wide-ranging implications in tissue kinetics. 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