# Screening for oncogenic AF1q expression predicts disease recurrence in gastric cancer patients

## TL;DR

High AF1q expression in gastric cancer is linked to disease recurrence and can help predict outcomes for patients.

## Contribution

AF1q is identified as an independent prognostic marker for recurrence-free survival in gastric cancer patients.

## Key findings

- High AF1q expression correlates with lymph node stage and worse recurrence-free survival in gastric cancer.
- CD44 expression is associated with reduced disease-specific survival in both nodal-positive and overall gastric cancer groups.
- AF1q and CD44 are independent prognostic markers for recurrence and survival in gastric cancer patients.

## Abstract

AF1q associates with tumor progression and metastases upon WNT signaling. The downstream WNT target CD44 has demonstrated prognostic significance in gastric cancer (GC). This study evaluates the impact of AF1q on tumor stage and survival in GC patients. Immunohistochemical marker expression was analyzed and data were processed to correlation and survival analysis. Out of 182 GC samples, 178 (97.8%) showed moderate to high AF1q expression (p < 0.001), these samples correlated with positive lymph node stage (p = 0.036). In a subgroup analysis of patients with nodal-positive GC (n = 129, 70.9%), enhanced tumoral AF1q expression resulted in impaired recurrence-free survival (RFS, p = 0.030). Enhanced tumoral CD44 expression resulted in impaired disease-specific survival (DSS) in the subgroup of patients with nodal-positive GC (p = 0.031) as well as in the overall GC group (p = 0.005). AF1q demonstrated as an independent prognostic marker for RFS (p = 0.035) and CD44 for DSS (p = 0.036). AF1q has shown potential for prognostication of RFS in GC patients and is predominantly expressed in nodal-positive GC. Testing AF1q provides a possibility of identifying patients with locoregional (and advanced) disease, particularly at risk for disease recurrence. Implementing AF1q into the diagnostic process may facilitate screening, prognosis estimation as well as consideration of preoperative multimodal treatment in patients qualifying for elective upfront surgery.