Wu I-Chen, Wang Yao-Kuang, Chen Yi-Hsun, Wu Chun-Chieh, Wu Meng-Chieh, Chen Wei-Chung, Wang Wen-Lun, Lin Hung-Shun, Chen Chou-Cheng, Chou Shah-Hwa, Liu Yu-Peng, Wu Ming-Tsang
Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
Department of Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
Cancers (Basel). 2021 Jun 21;13(12):3082. doi: 10.3390/cancers13123082.
Esophageal squamous cell carcinoma (ESCC) is a highly aggressive tumor known to have locally advanced and metastatic features which cause a dismal prognosis. We sought to determine whether elafin, a non-invasive and secretory small-molecule marker, could be used to predict prognosis in locoregional ESCC patients in human and in vitro studies. In our human study, 119 subjects were identified as having incident and pathologically-proved ESCC with stage I-IIIA tumors from southern Taiwan between 2000 and 2016. We measured their serum elafin levels at baseline and followed them until the date of cancer death or until January 2020, the end of this study. Those with high serum elafin levels were found to have a 1.99-fold risk (95% confidence interval: 1.17-3.38) shorter survival than those who did not. In our in vitro experiments, elevated elafin levels were found to drive ESCC cell proliferation, migration and invasion, while attenuation of elafin level by shRNA abrogated those effects. We concluded that elafin promotes ESCC motility and invasion and leads to a worse clinical prognosis in ESCC patients without distant metastasis.
食管鳞状细胞癌（ESCC）是一种侵袭性很强的肿瘤，具有局部进展和转移的特征，预后较差。我们试图确定elafin（一种非侵入性分泌型小分子标志物）是否可用于预测局部区域ESCC患者在人体和体外研究中的预后。在我们的人体研究中，119名受试者被确定为2000年至2016年间来自台湾南部患有I-IIIA期肿瘤的初发且经病理证实的ESCC患者。我们在基线时测量了他们的血清elafin水平，并对他们进行随访，直至癌症死亡日期或直至本研究结束的2020年1月。发现血清elafin水平高的患者的生存风险是血清elafin水平不高患者的1.99倍（95%置信区间：1.17 - 3.38），生存时间更短。在我们的体外实验中，发现elafin水平升高会促进ESCC细胞的增殖、迁移和侵袭，而通过shRNA降低elafin水平则可消除这些作用。我们得出结论，elafin促进ESCC的运动性和侵袭性，并导致无远处转移的ESCC患者临床预后更差。
