Faculty of Medicine and University Hospital of Cologne, Department of General, Visceral and Cancer Surgery, University of Cologne, Cologne, Germany.
Faculty of Medicine and University Hospital of Cologne, Institute of Pathology, University of Cologne, Cologne, Germany.
BMC Cancer. 2023 Jul 17;23(1):669. doi: 10.1186/s12885-023-11146-0.
Patients diagnosed with esophageal cancer demonstrate a low overall survival even despite the established multimodal therapy as the current standard of care. Therefore, further biomarkers for patients with high-risk and additional therapy options are needed. NANOG is a transcription factor, which can be found in stem cells and is known to support tumorigenesis.
Six hundred sixty patients with esophageal adenocarcinoma, who were operated at the University of Cologne with a curative intent, were included. Immunohistochemical stainings for NANOG were performed. The study population was divided into NANOG-positive and -negative subgroups.
Positive NANOG expression correlates significantly with worse overall survival (p = 0.002) and could be confirmed as an independent risk factor for worse patient survival in multivariate analysis (HR = 1.40, 95%CI = 1.09-1.80, p = 0.006). This effect could be detected in the subgroup of primarily operated patients, but not in patients after neoadjuvant therapy.
We describe a NANOG-positive subgroup of patients with esophageal cancer, who exhibit worse overall survival in a large patient cohort. This discovery suggests the potential use of NANOG as a biomarker for both intensified therapy and stricter follow-up regimes. Additionally, NANOG-positive stem cell-like cancer cells could be used as a new antitumoral treatment target if validated in mechanistic and clinical studies.
即使采用当前标准的多模式治疗，诊断为食管癌的患者的总体生存率仍然很低。因此，需要寻找更多的生物标志物来识别高危患者，并提供更多的治疗选择。NANOG 是一种转录因子，存在于干细胞中，已知其能促进肿瘤发生。
本研究纳入了在德国科隆大学接受根治性手术的 660 例食管腺癌患者。采用免疫组织化学方法检测 NANOG 的表达。将研究人群分为 NANOG 阳性和阴性亚组。
NANOG 阳性表达与总体生存率显著相关（p=0.002），并在多变量分析中被证实为影响患者生存的独立危险因素（HR=1.40，95%CI=1.09-1.80，p=0.006）。这一影响仅在主要接受手术治疗的亚组中观察到，而在接受新辅助治疗的患者中则未观察到。
我们描述了一个具有 NANOG 阳性表达的食管癌患者亚组，在一个大型患者队列中，该亚组的总体生存率更差。这一发现提示了 NANOG 作为生物标志物的潜在用途，可用于强化治疗和更严格的随访方案。此外，如果在机制和临床研究中得到验证，NANOG 阳性的干细胞样癌细胞可能成为一种新的抗肿瘤治疗靶点。
