WRAP53 Expression In Esophageal Squamous Cell Carcinoma And The Association With Radiosensitivity And Prognosis

Objective: The purpose of this study to analyze the difference of WRAP53 expression in esophageal squamous cell carcinoma tissues and mucous membrane tissues of normal people cohorts and the relationship of WRAP53 with clinicopathological characteristics, radiotherapy response and prognosis of patients with ESCC, to investigate whether it can be useful as a predictive biomarker for the radiotherapy and prognosis of,in order to provide new foundation for choosing individual diagnosis and treatment scheme in patients with ESCC.Methods: 1.Clinical data of 82 ESCC patients,who had received complete curative radiotherapy from radiotherapy department of Affiliated Hospital of North Sichuan Medical College,were retrospectively analyzed,meanwhile their tumor tissues before radiotherapy and mucosa tissues of 20 normal people cohorts were provided by department of pathology.The expression of WRAP53 protein was examined employing immunohistochemistry. The difference of WRAP53 expression between tumor tissues and normal esophageal mucous membrane tissues, and the relationship of WRAP53 with clinicopathological characteristics, radiotherapy response and prognosis of patients with ESCC were analyzed.2.All patients were treated with radiotherapy with MV-X ray linear accelerator. The curative effect was evaluated based on X-ray film within three months after radiotherapy.3.The latest follow-up time of 82 patients with ESCC was February 22, 2016. The excel database including clinicopathological characteristics and follow-up information was established.4.All statistical analyses were performed using SPSS19.0. Median was calculated in excel.Chi-squared test was used to test association between different variables.Survival analysis was performed using Kaplan-Meier and Cox proportional hazard.Results: 1.The WRAP53 protein,stained as yellow or brownish,was dominantly located in the nucleus of ESCC.About 61%(50/82) tumor tissues were positive for WRAP53,however only 30%(6/20)were positive in esophageal mucosa tissues of normal people cohorts. Statistical analysis revealed significant difference for WRAP53 expression between tumor tissues and normal esophageal mucosa tissues(χ2=6.2,P<0.05).2.The expression of WRAP53 protein was not correlated with age,gender, the site of lesion, the length of tumor, the maximum diameter of tumor, lymph node metastasis status, the invasion degree of surrounding tissues, the primary tumor stage, clinical stage, primary tumor volume(GTV-T)(all P > 0.05).3.82 cases of ESCC patients had finished the radiotherapy. There were no serious adverse reactions happened during the treatment. The curative effect was evaluated based on X film within three months after radiotherapy.64 cases of ESCC patients were sensitive to radiotherapy(CR+PR),18 cases showed resistance to radiotherapy(NR).Positive WRAP53 expression rates were 67%(43/64) in radiosensitivity group,however 39%(7/18) were negative expression in radioresistance group. Pearson’s chi-aquared test showed that there was statistic difference between the groups(X2=4.726, P<0.05).4.Progress free survival and overall survival in positive WRAP53 expression groups were longer than ones in the negative WRAP53 expression groups. 3 year progress free survival rates in positive WRAP53 expression groups were 48.6%,ones in negative WRAP53 expression groups were 11.7 %.3 year overall survival rates in positive WRAP53 expression groups were 53.7%,ones in negative WRAP53 expression groups were 17.4 %. Kaplan-Meier univariate survival analysis revealed statistically significant difference in overall survival between the groups. Cox proportional hazard model multivariate analysis also implied that positive WRAP53 expression was correlated with improved progression free survival(HR=0.48,95%CI=0.27-0.86,P=0.014)and overall survival(HR=0.51,95%CI=0.27-0.95,P=0.034).Conclusions: 1.Frequency of WRAP53 protein expression is increased in ESCC tissues compared to the mucous membrane tissues of normal people cohorts.2.The relationship between WRAP53 protein expression and clinicopathological characteristics of esophageal squamous cell carcinoma patients is not found in this study.3.Among 82 cases of ESCC patients,the expression of WRAP53 protein is higher in radiosensitivity group than radioresistance group,WRAP53 may be a novel predictive maker for response to the radiotherapy in patients with ESCC.4.This study showes that the patients received radiotherapy with positive WRAP53 expression have better prognosis than the negative ones. Positive WRAP53 could improve life quality of patients,and might be one of good prognosis predictors in ESCC patients received curative radiotherapy.