Jinrong Hao Xia Yu ^* Xiong Lei ^* Li Deng ^* Shifeng Lian Yun Du Shijun Sun ^* Xiaoling Li ^* Mingfang Ji ^*

• Zhongshan People's Hospital (ZSPH), Zhongshan, Guangdong, China

Nasopharyngeal carcinoma (NPC) is a highly invasive malignant tumor. Recurrence and distant metastasis are the common patterns of treatment failure. This study aimed to identify biomarkers highly associated with NPC and investigate its roles in tumor progression. By analyzing the transcriptome sequencing (RNA-seq) data, we found that G Protein Subunit Alpha 14 (GNA14) is closely associated with the diagnosis and prognosis of NPC. Immunohistochemistry (IHC) was used to detect the expression of GNA14 in tumor tissues of 165 NPC patients. We analyzed the relationship between GNA14 expression and NPC prognosis. Analysis of RNA-seq data and IHC showed that GNA14 expression was downregulated in NPC (p < 0.001, p < 0.01, respectively).Low expression of GNA14 was closely associated with poor prognosis. IHC analysis showed that patients with low GNA14 expression had significantly shorter progression-free survival (PFS) and distant metastasis-free survival (DMFS) than those with high GNA14 expression (p = 0.023, p = 0.008, respectively). Multivariate analysis indicated that the GNA14 expression was an independent risk factor for DMFS (p = 0.030). The nomogram included GNA14 expression, EBV DNA, and N stage as prognostic factors and the concordance index (C-index) of the DMFS nomogram was 0.73. Bioinformatics analysis indicated that NPC patients with low GNA14 expression might represent lower levels of immune cell infiltration and poorer drug sensitivity. In conclusion, our findings highlight that low GNA14 expression may be a risk factor for poor prognosis in NPC.