Abstract. p53 and microtubule-associated protein 1 light chain 3A (LC3A) are regulators of apoptosis and autophagy and are expressed at high levels in a number of human tumors. The purpose of the current study was to evaluate the clinicopathological and prognostic significance of p53 and LC3A expression levels in esophageal squamous cell carcinomas (ESCCs). p53 and LC3A expression levels were measured by immunohistochemistry in 114 patients with stage II/III (T any N+M 0 or T 3,4 N any M 0 ) ESCCs treated with surgery followed by adjuvant concurrent chemoradiotherapy. The overexpression of p53 and LC3A was observed in 57 and 54% of ESCC samples, respectively. p53 staining was nuclear and LC3A was localized to the cytoplasm of tumor cells. p53 overexpression was more frequently observed in ESCCs with positive lymph nodes (P=0.017). Patients with ESCCs overexpressing p53 and LC3A were associated with a lower 5-year overall survival rate than those with low p53 and LC3A expression (18.0 vs. 54.4%; P=0.001). Univariate and multivariate analyses revealed that the overexpression of p53 or LC3A was not associated with poor patient outcome (P>0.05). However, patients with high levels of p53 and LC3A co-expression had poor clinical prognoses (P=0.027). Thus, p53 and LC3A co-expression is an independent prognostic marker for patients with ESCC.
IntroductionEsophageal carcinoma (EC) is a public health issue in China (1). It has a poor overall prognosis and treatment outcomes for patients with EC have not improved over the last few decades. Significant prognostic indicators include the extent of invasion and lymph node and distal metastases (2). However, specific patients with the same stage have different prognosis (3). Therefore, molecular markers to improve the outcome prediction for patients with EC must be identified.Classified as type I programed cell death, apoptosis is involved in a number of cancer-related processes, including tumorigenesis, tumor progression and cellular responses to chemotherapy and radiotherapy (4-6). The well-studied tumor suppressor protein, p53, is key to apoptosis and cancer development. Wild-type p53 inhibits tumor growth by inducing apoptosis and inhibiting angiogenesis and metastasis; however, the TP53 gene undergoes inactivating mutations in a variety of cancer types. More recently, p53 has been demonstrated to repress autophagy (7), indicating that apoptosis and autophagy may interact. Type II programmed cell death, or autophagy, is an evolutionarily conserved eukaryotic process important for maintaining homeostasis by recycling stable proteins and long-lived organelles (8).Autophagy is important in a number of physiological processes, including adaptation to hypoxia, prevention of tumorigenesis and antigen presentation (9-11). Although the role of autophagy in cancer is unclear, the current view is that it functions as a cytoprotective mechanism during tumor progression (12).Previously, microtubule-associated protein 1 light chain 3A (LC3A), one of three microtubule-associated protein ...