Overexpression of HOXA10 promotes gastric cancer cells proliferation and HOXA10+/CD44+ is potential prognostic biomarker for gastric cancer

Gastric cancer (GC) is a malignant cancer with poor prognosis. This study aims to investigate the roles of homeobox A10 (HOXA10) in GC and the correlations between HOXA10/CD44 expression and GC prognosis. Based on qRT-PCR and Western Blot analyses in 50 pairs of fresh GC samples and adjacent normal samples, it is identified that HOXA10 was significantly up-regulated in GC tissues at mRNA and protein levels. Cell proliferation, migration, and invasion were enhanced in GC cells with overexpressed HOXA10, while inhibited in cells with silenced HOXA10. Through IPA software, HOXA10 was predicted to interact with CD44 via MSN, which was preliminarily confirmed by using Western Blot. Through immunohistochemistry and tissue microarray (N = 264), it is found that HOXA10 expression was significantly correlated with tumor size (P = 0.011) and CD44 expression (P < 0.001), while CD44 expression was significantly correlated with tumor size (P < 0.001), depth of tumor invasion (P < 0.001), lymph node metastasis (P < 0.001), distant metastasis (P = 0.001), UICC stage (P < 0.001), histological differentiation (P < 0.001), and HOXA10 expression (P < 0.001). Additionally, the over-all survival and disease-free survival of HOXA10+/CD44+ patients were dramatically decreased in comparison with that of HOXA10+/CD44−, HOXA10−/CD44+, or HOXA10−/CD44− patients (P < 0.001), suggesting that the combinatory expression of HOXA10 and CD44 was correlated with poor GC prognosis. In conclusion, HOXA10 and CD44 might play roles in GC tumorigenesis, metastasis, and invasion. HOXA10+/CD44+ expression might serve as a prognostic biomarker for GC, which needs more studies to validate.