{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T11:26:59Z","timestamp":1771932419960,"version":"3.50.1"},"reference-count":43,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Nasopharyngeal carcinoma (NPC), characterized by the infiltration of lymphocytes, is a malignancy derived from the epithelium of the nasopharynx. Despite its sensitivity to radiation and chemotherapy, NPC has a high propensity for recurrence and metastasis. Although lymph node levels have been indicated as an independent prognostic factor for NPC, there has been no precise prognostic biomarker to predict clinical outcomes for NPC before advanced disease. In the present study, we surveyed differentially expressed genes in NPC via the next-generation sequencing (NGS)-based Oncomine database and identified the spindlin family member 4 (SPIN4) gene as the most relevant to advanced nodal status. We collected 124 tumor samples from NPC patients receiving biopsy, and the expression level of SPIN4 was evaluated by immunohistochemistry. The results showed that tumors with high SPIN4 expression were significantly correlated with advanced nodal status (p &lt; 0.001) and advanced AJCC stages (p &lt; 0.001). High SPIN4 expression in tumor samples was an unfavorable prognostic factor for all three endpoints at the univariate level: disease-specific survival (DSS), distal metastasis-free survival (DMeFS), and local recurrence-free survival (LRFS) (all p &lt; 0.05). High SPIN4 expression remained independently prognostic of worse DMeFS (p = 0.049) at the multivariate level. Using bioinformatics analysis, we further found that high SPIN4 level may link tight junctions to cancer cell survival. Collectively, these results imply that high SPIN4 expression is linked to an aggressive clinical course, including advanced nodal status and poor survival in NPC patients, emphasizing the promising prognostic utility of SPIN4 expression.<\/jats:p>","DOI":"10.3390\/life11090912","type":"journal-article","created":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T11:39:03Z","timestamp":1630496343000},"page":"912","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["High SPIN4 Expression Is Linked to Advanced Nodal Status and Inferior Prognosis in Nasopharyngeal Carcinoma Patients"],"prefix":"10.3390","volume":"11","author":[{"given":"Shih-Lun","family":"Chang","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Chi Mei Medical Center, Tainan 710, Taiwan"},{"name":"Department of Optometry, Chung Hwa University of Medical Technology, Tainan 717, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ti-Chun","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Chi Mei Medical Center, Tainan 710, Taiwan"},{"name":"National Institute of Cancer Research, National Health Research Institute, Tainan 704, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tzu-Ju","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathology, Chi Mei Medical Center, Tainan 710, Taiwan"},{"name":"Institute of Biomedical Science, National Sun Yat-Sen University, Kaohsiung 804, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3823-4673","authenticated-orcid":false,"given":"Ching-Chieh","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Chi Mei Medical Center, Tainan 710, Taiwan"},{"name":"Department of Pharmacy, Chia-Nan University of Pharmacy and Science, Tainan 717, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsin-Hwa","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Chi Mei Medical Center, Tainan 710, Taiwan"},{"name":"Department of Clinical Pathology, Chi Mei Medical Center, Tainan 710, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheng-Fa","family":"Yeh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Chi Mei Medical Center, Tainan 710, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sung-Wei","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Chi Mei Medical Center, Liouying 736, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6197-9828","authenticated-orcid":false,"given":"Hong-Yue","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Chi Mei Medical Center, Tainan 710, Taiwan"},{"name":"Department of Clinical Pathology, Chi Mei Medical Center, Tainan 710, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,1]]},"reference":[{"key":"ref_1","first-page":"3687","article-title":"Nasopharyngeal carcinoma: A review of current updates","volume":"15","author":"Wu","year":"2018","journal-title":"Exp. 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