POU6F1 Expression Predicts Favorable Prognosis in Lung Adenocarcinoma: Validation Using Patient Cohort and TCGA Data

Non-small cell lung cancer (NSCLC) is the most common type of lung cancer and remains a leading cause of cancer-related mortality worldwide. Lung adenocarcinoma (AD) and lung squamous cell carcinoma (SCC) represent the two major histological subtypes with distinct molecular characteristics. POU domain class 6 transcription factor 1 (POU6F1) is involved in gene regulation and cellular differentiation, but its clinical significance in NSCLC remains unclear. This study investigated the clinicopathologic and prognostic significance of POU6F1 expression in NSCLC. POU6F1 mRNA expression was analyzed in tumor tissues obtained from 153 patients with NSCLC using quantitative real-time polymerase chain reaction. The associations between POU6F1 expression and clinicopathological characteristics were evaluated, and survival analysis was performed to determine its prognostic value. In addition, publicly available datasets from The Cancer Genome Atlas (TCGA) were analyzed to validate the clinical significance of POU6F1 expression. High POU6F1 expression was observed in 48 patients (31.4%), whereas 105 patients (68.6%) showed low expression. High POU6F1 expression was significantly associated with younger age (p = 0.027), female sex (p = 0.041), non-smoking status (p = 0.002), adenocarcinoma histology (p = 0.021), and the presence of EGFR mutations (p = 0.038). Survival analysis demonstrated that high POU6F1 expression was associated with improved overall survival in patients with NSCLC (p = 0.015). When stratified by histological subtype, higher POU6F1 expression was associated with better survival outcomes in AD but not in SCC. Analysis of TCGA datasets confirmed that elevated POU6F1 expression was significantly associated with favorable survival in AD, whereas no significant prognostic value was observed in SCC. POU6F1 expression is significantly associated with clinicopathological characteristics and improved survival in patients with lung AD. Multivariate Cox regression analysis further confirmed that POU6F1 expression was an independent prognostic factor for overall survival. These findings suggest that POU6F1 may serve as a potential prognostic biomarker based on mRNA expression in NSCLC, particularly in AD. Further studies are warranted to validate these findings at the protein level and to elucidate the underlying biological mechanisms.