Expression of carboxylesterase 4A in nasopharyngeal carcinoma and its prognosis and immune infiltration analysis

Objective: To investigate the aberrant expression of carboxylesterase 4A(CES4A) in nasopharyngeal carcinoma(NPC) and its potential association with prognosis of patients and immune infiltration. Methods: Reverse transcription-quantitative PCR(RT-qPCR) and immunohistochemical staining were utilized to assess the mRNA and protein expression levels of CES4A in NPC tissues. The relationship between CES4A expression levels and clinical pathological characteristics as well as survival time of patients was analyzed. GO, KEGG, and immune correlation analyses were conducted using R language. Results: Compared with normal nasopharyngeal tissues, CES4A mRNA and protein expression levels in NPC were significantly decreased, but there was no significant correlation with clinical pathological characteristics of NPC. Receiver operating characteristic(ROC) curves were plotted based on the GEO dataset, RT-qPCR and immunohistochemical staining data, and the area under the curve(AUC) was 0.850(P<0.05), 0.6654(P=0.0037) and 0.8098(P=0.0019), respectively. Patients with low CES4A expression exhibited poor prognosis(P<0.001), with CES4A identified as an independent prognostic factor for NPC patients(P=0.00436, HR=0.168, 95% CI:=0.0492-0.5730). CES4A was positively correlated with tumor infiltration of B cells. Conclusion: Down-regulation of CES4A expression in NPC may serve as a reliable molecular marker for the diagnosis and poor prognosis in NPC patients. Additionally, its association with the reduced tumor infiltration of B cells suggests that CES4A can be a potential therapeutic target for NPC.