Jia Ruinuo, Mi Youjia, Yuan Xiang, Kong Dejiu, Li Wanying, Li Ruonan, Wang Bingbing, Zhu Yafei, Kong Jinyu, Ma Zhikun, Li Na, Mi Qiangjian, Gao Shegan
Cancer Hospital, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, Henan 471000, China.
College of Clinical Medicine of Henan University of Science and Technology, Luoyang, Henan 471000, China.
J Oncol. 2020 Jan 30;2020:1607860. doi: 10.1155/2020/1607860. eCollection 2020.
Neoadjuvant chemotherapy (NCT) is a standard care for esophageal squamous cell carcinoma (ESCC), but the efficacy is unsatisfactory. Cancer stem cells (CSCs) play key roles in chemotherapy resistance. Gene amplified in squamous cell carcinoma 1 (GASC1) is a neoteric gene in stemness maintaining of ESCC. We aimed to reveal whether GASC1 could be a predictive biomarker for NCT in ESCC. ESCC patients (T2-4N0-2M0) were evaluated for GASC1 expression using immunohistochemical staining and classified as GASC1-low group (GLG) and GASC1-high group (GHG). NCT was delivered in two cycles and then the surgery was completed. Primary endpoints were tumor regression grade (TRG) and objective response rate (ORR); secondary endpoints were radical surgical resection (R0) rate and three-year overall survival (OS). 60 patients were eligible with evaluable outcomes: 24 in GHG and 36 in GLG. Between GHG and GLG, TRG1, TRG2, TRG3, and TRG4 were 0 : 16.7%, 20.8% : 41.7%, 58.3% : 36.1%, and 20.8% : 5.6%, respectively (=0.006); ORR and R0 rate were 33.3% : 69.4% (=0.006) and 75% : 94.4% (=0.046), respectively; the median OS was 20 : 32 (months) (=0.0356). No significant difference in the three-year OS was observed between GHG and GLG: 29.2% : 41.7% (=0.24). Furthermore, the GASC1 expression level was associated with poor OS independent of other factors by univariate and multivariate analyses. Therefore, GASC1 might be a potential biomarker to predict NCT efficacy for ESCC.
新辅助化疗（NCT）是食管鳞状细胞癌（ESCC）的标准治疗方法，但疗效并不理想。癌症干细胞（CSCs）在化疗耐药中起关键作用。鳞状细胞癌中扩增的基因1（GASC1）是ESCC干性维持中的一个新基因。我们旨在揭示GASC1是否可以作为ESCC中NCT的预测生物标志物。使用免疫组织化学染色评估ESCC患者（T2-4N0-2M0）的GASC1表达，并分为GASC1低表达组（GLG）和GASC1高表达组（GHG）。进行两个周期的NCT，然后完成手术。主要终点是肿瘤退缩分级（TRG）和客观缓解率（ORR）；次要终点是根治性手术切除（R0）率和三年总生存率（OS）。60例患者符合条件且结果可评估：GHG组24例，GLG组36例。GHG组和GLG组之间，TRG1、TRG2、TRG3和TRG4分别为0∶16.7%、20.8%∶41.7%、58.3%∶36.1%和20.8%∶5.6%（=0.006）；ORR和R0率分别为33.3%∶69.4%（=0.006）和75%∶94.4%（=0.046）；中位OS为20∶32（个月）（=0.0356）。GHG组和GLG组之间在三年OS方面未观察到显著差异：29.2%∶41.7%（=0.24）。此外，通过单因素和多因素分析，GASC1表达水平与较差的OS相关，且独立于其他因素。因此，GASC1可能是预测ESCC中NCT疗效的潜在生物标志物。
