Expression And Prognostic Value Of Nrf2,Ho-1,Bcl-2 And Bax In Esophageal Squamous Cell Carcinoma And Precancerous Lesions

Objective : The expression of Nrf2 and HO-1 in esophageal squamous cell carcinoma(ESCC)and precancerous esophageal lesions was detected,and The relationship between clinicopathological parameters and prognosis was analyzed.Methods: Immunohistochemical(IHC)staining was used to detect the relative expression levels of Nrf2,HO-1,Bcl-2,and Bax in 61 cases of low-grade intraepithelial neoplasia,57 cases of high-grade intraepithelial neoplasia,237 cases of ESCC tissue,and 217 cases of adjacent normal tissues.To analyze the relationship between Nrf2,HO-1,Bcl-2 and Bax expression and clinicopathological parameters in ESCC.The Kaplan-Meier survival curve analyzed the overall survival(OS)and 5-year progression-free survival(PFS)prognosis of ESCC patients with different expression modes of Nrf2,HO-1,Bcl-2 and Bax.Spearman analyzed the correlation of Nrf2,HO-1,Bcl-2 and Bax in esophageal squamous cell carcinoma,high-grade intraepithelial neoplasia and low-grade intraepithelial neoplasia,respectively.Results: The relative expression of Nrf2,HO-1 and Bcl-2 is higher in esophageal squamous cell carcinoma and precancerous tissues than in paracancerous tissues,while the relative expression of Bax is lower in esophageal squamous cell carcinoma and precancerous lesions.lymph node metastasis are associated with Nrf2 overexpression.Degree of differentiation,lymph node metastasis,vascular invasion,distant metastasis,and Joint Commission on American Cancer(AJCC)staging are all associated with HO-1 overexpression.High expression of Bcl-2 is associated with the degree of tumor differentiation.Bax low expression is associated with AJCC staging.Patients with high Nrf2,HO-1,Bcl-2 expression,and Bax low expression have shortened overall survival(OS).High expression of Bcl-2 and lymph node metastasis are independent prognostic factors for esophageal squamous cell carcinoma.Nrf2 expression may be associated with lower immune cell infiltration.Conclusion : 1.The expression of Nrf2,HO-1 and Bcl-2 plays a role in promoting the progression and carcinogenesis of esophageal squamous epithelial lesions,while the expression of Bax has a protective effect in esophageal squamous cell carcinoma.2.Nrf2 and Bcl-2 are correlated with poor prognosis of esophageal squamous cell carcinoma,and can be used as one of the predictors for evaluating malignant progression in patients with esophageal squamous cell carcinoma.