Nrf2 expression is associated with poor outcome in osteosarcoma

SummaryAimsNF-E2-related factor 2 (Nrf2) is involved in defence against oxidative stress in human cells. Nrf2 is overexpressed in many types of cancers suggesting that it plays a role in carcinogenesis and chemoresistance. We examined Nrf2 expression in osteosarcoma to determine its prognostic significance.MethodsNrf2 expression was assessed using immuno- histochemistry in 58 specimens from patients with osteosarcoma. We investigated whether Nrf2 expression was associated with clinicopathological parameters.ResultsNrf2 was positively expressed in 19 (32.8%) of 58 specimens. Nrf2 expression in osteosarcoma indicated a poor prognostic outcome (p = 0.0074), and correlated with worse disease-free survival (p = 0.0279). Nrf2 expression had a significant relationship with histological subtype (osteoblastic versus non-osteoblastic, p = 0.042); the nonosteoblastic subtype showed a higher rate of Nrf2 expression (50.0%) than the osteoblastic subtype (23.7%). Nrf2 expression showed no significant relationship with response to neoadjuvant chemotherapy (p = 0.115). Other clinicopatho- logical parameters had no relationship with Nrf2 expression.ConclusionIncreased expression of Nrf2 is associated with a poor outcome and disease-free survival in osteosarcoma. Our results suggest that Nrf2 is a possible marker of poor prognosis in osteosarcoma.