DATABASE-ITAC

Background/Objectives: Sinonasal intestinal-type adenocarcinoma (ITAC) is a rare and aggressive tumor that grows silently with non-specific symptoms, which leads to late diagnosis, and are characterized by frequent local recurrence and a low survival rate. The stemness phenotype is one of the main causes leading to tumor proliferation, recurrence, and resistance to standard chemo/radiotherapy. Methods: In this study, genes encoding pluripotency-associated transcription factors, including KLF4, c-MYC, SOX2, OCT4 (Yamanaka factors), and NANOG were evaluated in malignant and non-malignant tissues of a cohort of 54 patients with ITAC and their expression have been related to patient outcome. Results: The KLF4, SOX2, and NANOG best distinguished cancer tissue from normal tissue with high sensibility and specificity. Low levels of KLF4, c-MYC and NANOG and high expression of SOX2 and OCT4 in tumor tissue correlated with a poor overall survival (OS) and disease-free survival (DFS) in univariate analysis. The multivariate analysis confirmed SOX2 as an independent prognostic factor for OS and DFS. Conclusions: These findings support the concept that the presence of a stemness phenotype in ITAC, may be associated with the clinical response to treatment.