Research Report
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World J Gastroenterol. Apr 21, 2014; 20(15): 4414-4420
Published online Apr 21, 2014. doi: 10.3748/wjg.v20.i15.4414
Caspase-3 expression in metastatic lymph nodes of esophageal squamous cell carcinoma is prognostic of survival
Xiu-Shen Wang, Kong-Jia Luo, Amos Ela Bella, Shan-Shan Bu, Jing Wen, Shui-Shen Zhang, Yi Hu
Xiu-Shen Wang, Shan-Shan Bu, Department of Radiation Oncology, Cancer Hospital of Zhengzhou University, Zhengzhou 450008, Henan Province, China
Kong-Jia Luo, Amos Ela Bella, Jing Wen, Shui-Shen Zhang, Yi Hu, State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China
Kong-Jia Luo, Amos Ela Bella, Jing Wen, Shui-Shen Zhang, Yi Hu, Department of Thoracic Oncology, Cancer Center, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China
Kong-Jia Luo, Amos Ela Bella, Jing Wen, Shui-Shen Zhang, Yi Hu, Guangdong Esophageal Cancer Research Institute, Guangzhou 510080, Guangdong Province, China
Author contributions: Luo KJ and Bella AE drafted the article; Bu SS revised the manuscript; Weng J and Zhang SS provided the raw data; Wang XS and Hu Y designed the study. Wang XS, Luo KJ and Bella AE contributed equally to this work and share first authorship.
Correspondence to: Yi Hu, MD, PhD, Department of Thoracic Oncology, Cancer Center, Sun Yat-sen University, 651 Dong Feng Road East, Guangzhou 510080, Guangdong Province, China. huyi@sysucc.org.cn
Telephone: +86-20-87343401 Fax: +86-20-87343638
Received: September 5, 2013
Revised: October 27, 2013
Accepted: January 8, 2014
Published online: April 21, 2014
Processing time: 224 Days and 13 Hours
Abstract

AIM: To assess whether differential expression of caspase-3 in paired metastatic lymph nodes (LNs) is prognostic of survival in patients with resectable esophageal squamous cell carcinoma (ESCC).

METHODS: Capases-3 expression was evaluated immunohistochemically in 122 pairs of primary ESCCs and regional metastatic LNs assembled on tissue microarrays. The impact of caspase-3 expression on survival outcomes was analyzed by the Kaplan-Meier method and Cox proportional hazards regression model.

RESULTS: The level of caspase-3 expression was significantly higher in LN metastases than in primary tumors (P < 0.001). Caspase-3 expression in the primary tumors was associated with longer median survival (23 mo vs 21 mo, P = 0.033), whereas higher expression in paired metastatic LNs was associated with shorter median survival (20 mo vs 22 mo, P = 0.043). Multivariate analysis showed that both were independent prognostic factors.

CONCLUSION: Caspase-3 expression in metastatic LNs may be a potential independent predictor of poorer overall survival in patients with resected ESCC and LN metastasis. Protein expression in metastatic tumors may be a biomarker prognostic of survival.

Keywords: Esophageal squamous cell carcinoma; Caspase-3 protein; Prognosis; Lymph node

Core tip: Reduced caspase-3 expression in primary esophageal squamous cell carcinoma (ESCC) is associated with poorer outcomes, but the prognostic value of caspase-3 in metastatic lymph nodes (MLNs) is unclear. Analysis of 122 patients with primary ESCCs and paired MLNs showed that higher caspase-3 expression in MLNs from ESCC was associated with poorer prognosis. To the best of our knowledge, this study is the first to report the potential prognostic value of caspase-3 expression in MLNs of ESCC. Additional studies are needed to assess the prognostic importance of this biomarker.