High Cytoplasmic Expression of the Orphan Nuclear Receptor NR4A2 Predicts Poor Survival in Nasopharyngeal Carcinoma

Objective: This study aimed at investigating whether the orphan nuclear receptor NR4A2 is significantlyassociated with clinicopathologic features and overall survival of patients with nasopharyngeal carcinoma (NPC).Methods: Immunohistochemistry was performed to determine NR4A2 protein expression in 84 NPC tissues and20 non-cancerous nasopharyngeal (NP) tissues. The prognostic significance of NR4A2 protein expression wasevaluated using Cox proportional hazards regression models and Kaplan-Meier survival analysis. Results: Wedid not find a significant association between total NR4A2 expression and clinicopathological variables in 84patients with NPC. However, we observed that high cytoplasmic expression of NR4A2 was significantly associatedwith tumor size (T classification) (P = 0.006), lymph node metastasis (N classification) (P = 0.002) and clinicalstage (P = 0.017). Patients with higher cytoplasmic NR4A2 expression had a significantly lower survival ratethan those with lower cytoplasmic NR4A2 expression (P = 0.004). Multivariate Cox regression analysis analysissuggested that the level of cytoplasmic NR4A2 expression was an independent prognostic indicator for overallsurvival of patients with NPC (P = 0.033). Conclusions: High cytoplasmic expression of NR4A2 is a potentialunfavorable prognostic factor for patients with NPC.