Basic Study
Copyright ©The Author(s) 2016.
World J Gastroenterol. Oct 21, 2016; 22(39): 8770-8778
Published online Oct 21, 2016. doi: 10.3748/wjg.v22.i39.8770
Table 1 Distribution of selected variables in the esophageal basal cell hyperplasia, low-grade dysplasia, high-grade dysplasia, esophageal squamous cell cancer and control groups1n (%)
VariablesESCCHGDLGDBCHNormal control
Gender
Male89 (66.4)32 (62.7)146 (59.1)48 (62.3)40 (50.0)
Female45 (3.6)19 (37.3)101 (40.9)29 (37.7)40 (50.0)
Age (yr)
40-5052 (38.8)16 (31.4)60 (24.3)20 (26.0)7 (8.8)
50-6060 (44.8)25 (49.0)128 (51.8)34 (44.2)29 (36.3)
≥ 6022 (16.4)10 (19.6)59 (23.9)23 (29.9)44 (55.0)
School year (yr)
≤ 679 (59.0)20 (39.3)105 (42.5)32 (41.6)23 (28.8)
7-1150 (37.3)22 (43.1)98 (39.7)30 (39.0)36 (45.0)
≥ 125 (3.7)9 (17.6)44 (17.8)15 (19.5)21 (26.3)
Income per year-person ($)
< 15060 (44.8)22 (43.1)101 (40.9)26 (33.8)8 (10.0)
150-35056 (41.8)17 (33.3)92 (37.2)24 (31.2)21 (26.3)
≥ 35018 (13.4)12 (23.5)54 (21.9)27 (35.1)51 (63.8)
Family history of esophageal cancer
Yes19 (14.2)12 (23.5)50 (20.2)16 (20.8)8 (10.0)
No115 (85.8)39 (76.5)197 (79.8)61 (79.2)72 (90.0)
Smoking index2
≥ 45052 (38.8)23 (45.1)69 (27.8)31 (40.0)14 (17.7)
< 45025 (18.7)4 (7.8)40 (16.3)12 (16.0)16 (20.3)
None57 (42.5)24 (47.1)138 (55.9)34 (44.0)49 (62.0)
Alcohol drinking index3
≥ 12056 (42.0)16 (31.4)77 (31.0)22 (28.0)6 (7.5)
< 12028 (20.6)11 (21.6)44 (18.0)17 (22.7)29 (36.3)
None50 (37.4)24 (47.1)126 (51.0)38 (49.3)45 (56.3)
Table 2 Distribution of p53, CA19-9 and carcinoembryonic antigen expression in the five groups1n (%)
Protein expressionESCCHGDLGDBCHNormal control
p53
Negative63 (47.0)24 (47.1)159 (64.4)56 (72.7)64 (80.0)
Positive
1%-10%18 (13.4)17 (33.3)62 (25.1)17 (22.1)11 (13.8)
10%-25%20 (14.9)8 (15.7)20 (8.1)3 (3.9)5 (6.3)
25%-50%24 (17.9)2 (3.9)6 (2.4)1 (1.3)0 (0)
≥ 50%9 (6.8)0 (0)0 (0)0 (0)0 (0)
CA19-9
Negative75 (56.0)34 (66.7)206 (83.5)70 (90.8)75 (93.8)
Positive
1%-10%43 (32.1)15 (29.4)40 (16.1)6 (7.9)4 (5.0)
10%-25%13 (9.7)1 (2.0)1 (0.4)0 (0)1 (1.3)
≥ 25%3 (2.2)1 (2.0)0 (0)1 (1.3)0 (0)
CEA
Negative34 (25.4)20 (39.2)189 (76.7)59 (76.3)67 (83.8)
Positive
1%-10%47 (35.1)27 (52.9)56 (22.5)16 (21.1)7 (8.8)
10%-25%31 (23.2)4 (7.8)2 (0.8)1 (1.3)6 (7.5)
25%-50%19 (14.2)0 (0)0 (0)1 (1.3)0 (0)
≥ 50%3 (2.2)0 (0)0 (0)0 (0)0 (0)
Three biomarkers combined2
Negative21 (15.7)12 (23.5)129 (52.4)44 (57.1)58 (72.5)
Positive
1%-10%35 (26.1)26 (51.0)90 (36.4)28 (36.4)13 (16.3)
10%-25%30 (22.4)10 (19.6)22 (8.8)4 (5.2)9 (11.3)
25%-50%36 (26.8)3 (5.9)6 (2.4)1 (1.3)0 (0)
≥ 50%12 (9.0)0 (0)0 (0)0 (0)0 (0)
Table 3 The correlation coefficients for p53, CA19-9, CEA and selected variables
VariablesSpearman's correlation coefficient
p53CA19-9CEA
Age-0.0811-0.065-0.0931
School year0.1970.1390.213
Alcohol drinking index-0.050-0.056-0.021
Smoking index-0.038-0.050-0.003
Family history of esophageal cancer0.020-0.078-0.035
Degree of esophageal lesions30.28720.32620.4552
p5310.32520.3742
CA19-91.0000.5032
CEA1.000
Table 4 The associations of the positive expression of p53, CA19-9 and CEA proteins with basal cell hyperplasia, low-grade dysplasia, high-grade dysplasia, and esophageal squamous cell cancer [OR (95%CI)]
VariablesESCCHGDLGDBCH
p53
Model 114.51 (2.38-8.59)4.50 (2.07-9.78)2.21 (1.21-4.06)1.50 (0.71-3.15)
Model 224.52 (2.17-4.92)4.88 (2.10-11.33)2.31 (1.17-4.56)1.60 (0.72-3.57)
CA19-9
Model 1115.15 (7.45-30.84)7.99 (3.53-18.10)1.57 (0.81-3.04)1.60 (0.72-3.54)
Model 2223.57 (9.27-56.86)12.01 (4.61-31.32)2.05 (0.91-4.63)1.99 (0.81-4.93)
CEA
Model 1111.80 (4.49-31.05)7.50 (2.56-22.00)2.96 (1.13-7.76)1.52 (0.46-5.02)
Model 2217.40 (4.76-63.59)11.06 (2.80-43.71)3.80 (1.06-13.66)1.81 (0.41-7.96)
Three biomarkers combined3
Model 1114.19 (7.21-27.91)8.57 (3.80-19.30)2.40 (1.38-4.15)1.98 (1.02-3.85)
Model 2216.64 (7.68-36.05)10.11 (4.20-24.32)2.59 (1.38-4.86)2.15 (1.04-4.45)
Table 5 Area of receiver operating characteristic curves for p53, CA19-9, CEA and the three biomarkers combined in the four esophageal lesions
Protein expressionAreaSE95%CIZ valueP value
p53
ESCC0.6960.03570.629-0.7565.4830.001
HGD0.6690.04950.581-0.7493.4160.006
LGD0.5780.03560.523-0.6322.1970.028
BCH0.5330.04610.452-0.6130.7250.468
CA19-9
ESCC0.6500.03590.625-0.7515.288< 0.001
HGD0.6380.05090.549-7.2002.7140.007
LGD0.5540.03630.498-0.6091.4840.138
BCH0.5150.04640.433-0.5950.3170.751
CEA
ESCC0.8020.02930.742-0.85310.302< 0.001
HGD0.7120.04790.260-0.7884.423< 0.001
LGD0.5320.03690.476-0.5580.8720.383
BCH0.5310.04630.449-0.6110.6680.504
Three biomarkers combined1
ESCC0.8370.02600.780-0.884212.656< 0.001
HGD0.7400.04600.656-0.8135.220< 0.001
LGD0.5900.03520.535-0.6442.5860.010
BCH0.5620.04580.0481-0.6411.3600.174
Table 6 Diagnostic values of predicting the four esophageal lesions based on the positive expression of the three biomarkers combined at the cut off value of 10%-25%1 (%)
GroupSensitivity95%CI+PV95%CI
ESCC58.249.4-66.789.781.3-95.1
HGD25.514.3-39.659.136.4-79.3
LGD11.27.6-15.875.758.8-88.2
BCH6.52.2-14.535.712.9-64.8