Expression And Clinical Significance Of CHAF1A In Esophageal Squamous Cell Carcinoma

Background:According to the global cancer data in 2020,the esophageal cancer has the seventh highest incidence of cancer in the world and the sixth highest mortality rate.Esophageal squamous cell carcinoma(ESCC)is the most common histological type of esophageal carcinoma.In China,ESCC accounts for more than 90%of esophageal cancers.Chromatin assembly factor 1 subunit A(CHAF1A)is the largest subunit of Chromatin assembly factor 1,as well as its key factor and core component.Studies suggest that CHAF1A is highly expressed in a variety of tumors and it is related to the prognosis of tumors.Nonetheless,no studies have been conducted on CHAF1A and ESCC up till now.Objective:To explore the expression of CHAF1A in ESCC and its clinical significance.Methods:Pathological wax blocks were collected from 85 patients archived in the Department of Pathology of Pingxiang People’s Hospital from January 2015 to January 2020 and were divided into 4 groups:esophageal intraepithelial neoplasia group(10 cases),ESCC Ⅰ,Ⅱ,Ⅲ surgical resection group(26 cases),ESCC Ⅲ,Ⅳchemoradiotherapy group(39 cases),and esophageal inflammation group(10 cases)as control.Immunohistochemical staining was used to detect the expression of CHAF1A in each group to analyze the relationship between the expression of CHAF1A and the clinical characteristics of ESCC patients.By statistical analysis of the expression of CHAF1A in ESCC Ⅲ,Ⅳ chemoradiotherapy groups and the changes of target and non-target lesions after chemoradiotherapy,the relationship between the expression of CHAF1A in ESCC tissues and sensitivity to chemoradiotherapy was analyzed.The survival time of ESCC patients in each group were analyzed to explore the correlation between the expression of CHAF1A and 3-year overall survival rate of ESCC patients in each group.Results:The positive expression rates of CHAF1A were 20%(2/10),60%(6/10),65.4%(17/26)and 69.2%(27/39)in the esophageal inflammation group,the esophageal intraepithelial neoplasia group,the ESCC Ⅰ,Ⅱ,Ⅲ surgical resection group,and the ESCC Ⅲ,Ⅳ chemoradiotherapy group,respectively.The expression of CHAF1A in ESCC groups,esophageal intraepithelial neoplasia group and esophageal inflammation group had statistically significant differences(P<0.05).The expression of CHAF1A showed an increasing trend in esophageal inflammatory tissue,esophageal intraepithelial neoplasia tissue and ESCC tissue(P<0.05).CHAF1A protein overexpression in ESCC groups was correlated with lymph nodes and distant metastases of patients(P<0.05),while CHAF1A expression was not correlated with the depth of tumor invasion,extent of differentiation,tumor size,tumor site,smoking,alcohol consumption,age and gender differences of patients(P>0.05).In ESCC Ⅱ,Ⅳ chemoradiotherapy groups:After chemoradiotherapy,the remission of target and non-target lesions was more obvious in the CHAF1A low-expressed group than the high-expressed group(P<0.05).In the ESCC Ⅰ,Ⅱand III stage resection groups,the CHAF1A low-expressed group had higher 3-year overall survival than the higher one(P<0.05).In ESCC Ⅲ,Ⅳ chemoradiotherapy groups,the CHAF1A low-expressed group had higher 3-year overall survival than the high-expressed group(P<0.05).Conclusions:The CHAF1A was highly expressed in the ESCC tissues and esophageal intraepithelial neoplasia tissues,and low expressed in esophageal inflammatory tissues.The high expression of CHAF1A was closely related to lymph nodes and distant metastases in the ESCC patients,but not related to gender,age,smoking and drinking status,,tumor site and size,degree of differentiation,and depth of invasion.The higher the expression of CHAF1A protein in the ESCC tissue,the worse sensitivity of the patients to radiotherapy and chemotherapy.The higher the expression of CHAF1A in the ESCC tissues,the lower the 3-year overall survival rate and the worse prognosis.