Expression Of Periostin And EGFR In Esophageal Squamous Cell Carcinoma And Their Prognostic Significance

Objective Esophageal squamous cell carcinoma(ESCC)demonstrated the characteristics of insidious onset and it was difficult to be detected and diagnosed in early stage.Despite of improvements in the methods used for diagnosis and treatment of ESCC,the prognosis of patients with ESCC was not satisfactory.Therefore,it was urgent and necessary to find effective molecular biomarkers for monitoring the progression and survival time of patients with ESCC.Periostin(PO)and epidermal growth factor receptor(EGFR)were widely expressed in malignant solid tumors.PO,as an extracellular matrix protein,played an important role in the promotion of tumor proliferation,induction of tumor angiogenesis and chemoresistance.However,the correlation between the EGFR and PO,and whether their co-expression has an influence on the prognosis of ESCC patients were not clear.This study aimed to investigate the expression of PO and EGFR and their correlation,and analysze the influence of their expression on the survival time of ESCC patients,and explore their potential clinical value of targeted therapy in ESCC.Methods We collected 83 cases of ESCC patients with cancer and adjacent normal tissue specimens.Immunohistochemical method was used to detect the expression of PO and EGFR.The relationships between the expression level of PO and EGFR proteins and clinicopathological features were analyzed by c 2 test.The correlation between PO and EGFR was analyzed by Spearman correlation.Univariate Kaplan-Meier and multivariate Cox regression analysis were used to describe theeffects of PO and EGFR on the survival time of ESCC patients.Results In ESCC,the positive rate of PO expression was 71.1%(59/83)and the positive rate of EGFR was 73.5%(61/83),which were significantly higher than that in adjacent normal squamous epithelium(both P < 0.05).The high expression rate of PO and EGFR in total samples accounted for 56.6%(47/83)and 65.1%(54/83),respectively.Both high expression of EGFR and PO in ESCC were associated with lymph node metastasis(PO: P = 0.000;EGFR: P = 0.000)and tumor stage(PO: P =0.000;EGFR: P = 0.002).In addition,the high expression of PO was associated with tumor size,depth of invasion,and vascular invasion(all P < 0.05).The expression of PO was positively correlated with EGFR and the correlation coefficient was 0.531(P =0.000).Overall survival of patients in PO-high group and EGFR-high group was shorter than those in PO-low group and EGFR-low group,respectively(PO:29.191±2.528 months vs.53.688±2.719 months;EGFR: 31.796±2.222 months vs.54.108±3.609 months;both P<0.05).Alternatively,disease free survival of patients in PO-high group and EGFR-high group was also worse than those in PO-low group and EGFR-low group,respectively(PO: 18.766±2.449 months vs.44.396±3.796 months;EGFR: 20.500±2.117 months vs.46.517±4.575 months;both P < 0.05).High expression of PO and EGFR were also independent risk factors for the disease free survival and overall survival time of ESCC patients(both P < 0.05).PO and EGFR,as the independent prognostic factors,were analyzed for over survival time again by COX regression and the results indicated that the risk of death for ESCC patients with high expression of single biomarker and low expression of two biomarkers was 0.503 times(P = 0.030),0.243 times(P = 0.000),respectively,that for patients with high expression of two biomarkers.Conclusion PO and EGFR are all significantly increased in ESCC and are closely related to various pathological parameters.There is a positive correlation between PO and EGFR.PO and EGFR are independent prognostic factors for disease free survival and overall survival in ESCC.Co-expression of PO and EGFR is more closely to be of predictive value on ESCC development and progression.