Expression of stem cell marker musashi-1 and its relationship with survival prognosis in patients with resectable esophageal squamous cell carcinoma.

BACKGROUND

Esophageal squamous cell carcinoma (ESCC) is one of the most common malignant tumors globally, with its incidence particularly high in East Asia.

AIM

To analyze the expression of the stem cell marker musashi-1 in patients with resectable ESCC undergoing neoadjuvant chemotherapy and its relationship with patient survival prognosis.

METHODS

A retrospective analysis was conducted on the clinical data of 74 ESCC patients treated at our hospital from June 2020 to January 2022. All patients received neoadjuvant chemotherapy and surgical resection. Immunohistochemistry (IHC) was used to detect musashi-1 expression in tumor tissues. Based on the expression intensity, patients were divided into group A ( = 30, IHC total score > 2 indicating high expression) and group B ( = 44, IHC total score 0-2 indicating low expression). The clinical pathological differences between groups A and B were compared. The treatment outcomes of both groups were compared. Univariate and multivariate Cox regression analysis was performed to identify factors affecting patient prognosis. Kaplan-Meier survival analysis was used, and log-rank tests were conducted to compare differences between groups.

RESULTS

There were statistically significant differences in tumor maximum diameter, T stage, N stage, clinical stage, pathological grade, lymphovascular invasion, and intraoperative blood loss between groups A and B ( < 0.05). The disease control rate in group A (86.67%) was lower than that in group B (100.00%) ( = 3.868, = 0.049); the objective response rate in group A (33.33%) was lower than that in group B (70.45%) ( = 9.948, = 0.001). The proportion of tumor regression grade 3 + 4 + 5 grades in group A (80.00%) was higher than in group B (43.18%) ( = 9.933, = 0.001). Univariate analysis showed that tumor maximum diameter, T stage, N stage, clinical stage, pathological grade, and musashi-1 expression were associated with patient prognosis ( < 0.05). Cox regression analysis model. The results indicated that T stage [hazard ratio (HR) = 1.82, 95% confidence interval (CI): 2.14-7.37], N stage (HR = 1.70, 95%CI: 1.12-2.36), clinical stage (HR = 2.08, 95%CI: 1.36-3.85), pathological grade (HR = 1.54, 95%CI: 1.07-2.41), and musashi-1 expression (HR = 2.72, 95%CI: 2.03-4.11) were independent risk factors affecting patient prognosis ( < 0.05). Kaplan-Meier survival curves showed that the median overall survival in group A was 17 months, while in group B it was 28 months. Log-rank analysis revealed that the overall survival rate in group A was worse than in group B ( = 2.635, = 0.033).

CONCLUSION

The expression of musashi-1 is closely related to the treatment efficacy, prognosis, and survival of ESCC patients. It is expected to be a potential biomarker for evaluating the efficacy and survival prognosis of ESCC patients.