o:3499 Screening for oncogenic AF1q expression predicts disease recurrence in gastric cancer patients en 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. AF1q; CD44; Lymph node stage; Recurrence; Survival; Gastric cancer 1552099 10.1038/s41598-024-67058-x 2024-09-09T07:00:21.519Z 44 yes 46 Elisabeth S. Gruber Medical University of Vienna Georg Oberhuber Medical University of Vienna / PIZ - patho im zentrum GmbH person Michaela Schlederer Medical University of Vienna person Peter Birner Medical University of Vienna person Gerd Jomrich Medical University of Vienna person Sebastian F. Schoppmann Medical University of Vienna person William Tse Case Western Reserve University person Lukas Kenner University of Veterinary Medicine Vienna / Medical University of Vienna / Center For Biomarker Research In Medicine person 0000-0003-2184-1338 application/pdf 1538816 https://phaidra.vetmeduni.ac.at/o:3499 no yes 16 70 1552253 Scientific Reports 8 14 1 Nature 2024