Expression Status of Serine Protease 27: A Prognostic Marker for Esophageal Squamous Cell Carcinoma Treated with Preoperative Chemotherapy/Chemoradiotherapy

Ann Surg Oncol. 2021 Sep;28(9):5373-5381. doi: 10.1245/s10434-020-09550-y. Epub 2021 Jan 15.

Abstract

Background: A previous study conducted a transcriptome analysis of paired normal and esophageal squamous cell carcinoma (ESCC) tissue samples. The results showed that the expression of serine protease 27 (PRSS27) was perturbed in tumor samples. Hence, this retrospective study aimed to validate the prognostic significance of PRSS27 in patients with preoperative treatment for ESCC.

Methods: We enrolled 86 patients who received preoperative treatment before esophagectomy for ESCC. The expression of PRSS27 in resected ESCC and biopsy tissue samples obtained before preoperative treatment was evaluated via immunostaining, and its relationship with clinicopathological features and prognosis was analyzed.

Results: In normal esophageal mucosa tissue samples, PRSS27 was expressed in the cytoplasm of spinous cells in the suprabasal layer and basal cells in the basal layer. Of 64 resected ESCC tissue samples, 35 (54.7%) expressed PRSS27 and 29 (45.3%) did not. Moreover, ectopic nuclear expression of PRSS27 was observed. Based on multivariate analysis, PRSS27 expression in resected tumor samples was a predictor of poor prognosis. In cases in which PRSS27 expression was observed in biopsy samples, patients with PRSS27-negative resected tumors had a better postoperative prognosis than those with PRSS27-positive resected tumors.

Conclusions: PRSS27 expression in resected ESCC tissue samples is a poor prognostic factor in ESCC patients with preoperative treatment. Furthermore, conversion of PRSS27 expression from positive in biopsy samples to negative in resected tumor samples is a predictor of good prognosis in these patients. Hence, PRSS27 status is an effective tool for decision making regarding adjuvant treatment in ESCC patients.

MeSH terms

  • Biomarkers, Tumor / genetics
  • Carcinoma, Squamous Cell* / therapy
  • Chemoradiotherapy
  • Esophageal Neoplasms* / therapy
  • Esophageal Squamous Cell Carcinoma* / therapy
  • Head and Neck Neoplasms*
  • Humans
  • Prognosis
  • Retrospective Studies
  • Serine Endopeptidases
  • Serine Proteases

Substances

  • Biomarkers, Tumor
  • PRSS27 protein, human
  • Serine Proteases
  • Serine Endopeptidases