Prognostic Significance of c-MYC Amplification in Esophageal Squamous Cell Carcinoma

Ann Thorac Surg. 2019 Feb;107(2):436-443. doi: 10.1016/j.athoracsur.2018.07.077. Epub 2018 Sep 28.

Abstract

Background: We investigated the frequency of c-MYC amplification in esophageal squamous cell carcinoma (ESCC), including both stage I to II and III to IVa disease, and evaluated the correlation of c-MYC amplification with clinicopathologic variables and outcome.

Methods: In 259 ESCCs resected at Zhongshan Hospital, Fudan University, from January 2007 to November 2010, c-MYC amplification was analyzed by using tissue microarray, with fluorescence in situ hybridization assay.

Results: c-MYC gene amplification was found in 43.2% (112 of 259) of patients with ESCC. Significant differences were found between c-MYC amplification and patient age (p = 0.009) and lymph node metastasis (p = 0.046). The median follow-up period was 33 months (range: 4 to 102 months). A survival difference was found between patients with different c-MYC status. Among 112 patients with c-MYC amplification, a significantly poorer prognosis was observed, with a median disease-free survival (DFS) and overall survival (OS) of 24.0 and 31.0 months compared with 48.0 and 48.0 months, respectively, for patients without c-MYC amplification (p = 0.011 and 0.018). On univariate and multivariate analysis, site, clinical stage, lymph node metastasis, adjuvant therapy, and c-MYC amplification were associated with DFS and OS. When patients were divided into stage I to II and stage III to IV subgroups, c-MYC amplification tended to associate with poorer survival but without statistical difference (p > 0.05).

Conclusions: c-MYC amplification was associated with age and lymph node metastasis and was an independent poor-prognostic factor for DFS and OS in the full cohort of patients with ESCC.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / genetics
  • Biomarkers, Tumor / metabolism
  • DNA-Binding Proteins / genetics*
  • DNA-Binding Proteins / metabolism
  • Disease Progression
  • Disease-Free Survival
  • Endosonography
  • Esophageal Squamous Cell Carcinoma / diagnosis
  • Esophageal Squamous Cell Carcinoma / genetics*
  • Esophageal Squamous Cell Carcinoma / secondary
  • Female
  • Follow-Up Studies
  • Gene Amplification
  • Humans
  • In Situ Hybridization, Fluorescence
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Positron-Emission Tomography
  • Retrospective Studies
  • Time Factors
  • Tissue Array Analysis
  • Tomography, X-Ray Computed
  • Transcription Factors / genetics*
  • Transcription Factors / metabolism

Substances

  • Biomarkers, Tumor
  • DNA-Binding Proteins
  • MYCBP protein, human
  • Transcription Factors