title: A molecular prognostic model predicts esophageal squamous cell carcinoma prognosis.
abstract: BACKGROUND
  Esophageal squamous cell carcinoma (ESCC) has the highest mortality rates in China. The 5-year survival rate of ESCC remains dismal despite improvements in treatments such as surgical resection and adjuvant chemoradiation, and current clinical staging approaches are limited in their ability to effectively stratify patients for treatment options. The aim of the present study, therefore, was to develop an immunohistochemistry-based prognostic model to improve clinical risk assessment for patients with ESCC.
  
  
  METHODS
  We developed a molecular prognostic model based on the combined expression of axis of epidermal growth factor receptor (EGFR), phosphorylated Specificity protein 1 (p-Sp1), and Fascin proteins. The presence of this prognostic model and associated clinical outcomes were analyzed for 130 formalin-fixed, paraffin-embedded esophageal curative resection specimens (generation dataset) and validated using an independent cohort of 185 specimens (validation dataset).
  
  
  RESULTS
  The expression of these three genes at the protein level was used to build a molecular prognostic model that was highly predictive of ESCC survival in both generation and validation datasets (P = 0.001). Regression analysis showed that this molecular prognostic model was strongly and independently predictive of overall survival (hazard ratio = 2.358 [95% CI, 1.391-3.996], P = 0.001 in generation dataset; hazard ratio = 1.990 [95% CI, 1.256-3.154], P = 0.003 in validation dataset). Furthermore, the predictive ability of these 3 biomarkers in combination was more robust than that of each individual biomarker.
  
  
  CONCLUSIONS
  This technically simple immunohistochemistry-based molecular model accurately predicts ESCC patient survival and thus could serve as a complement to current clinical risk stratification approaches.
authors.affiliation: The Key Laboratory of Molecular Biology for High Cancer Incidence Coastal Chaoshan Area, Shantou University Medical College, Shantou, Guangdong, China; Institute of Oncologic Pathology, Shantou University Medical College, Shantou, Guangdong, China.
authors.forename: Hui-Hui
authors.initials: HH
authors.lastname: Cao
authors.affiliation: Departments of Oncology Surgery, Shantou Central Hospital, Affiliated Shantou Hospital of Sun Yat-sen University, Shantou, Guangdong, China.
authors.forename: Chun-Peng
authors.initials: CP
authors.lastname: Zheng
authors.affiliation: Departments of Pathology, Shantou Central Hospital, Affiliated Shantou Hospital of Sun Yat-sen University, Shantou, Guangdong, China.
authors.forename: Shao-Hong
authors.initials: SH
authors.lastname: Wang
authors.affiliation: The Key Laboratory of Molecular Biology for High Cancer Incidence Coastal Chaoshan Area, Shantou University Medical College, Shantou, Guangdong, China; Department of Biochemistry and Molecular Biology, Shantou University Medical College, Shantou, Guangdong, China.
authors.forename: Jian-Yi
authors.initials: JY
authors.lastname: Wu
authors.affiliation: Departments of Oncology Surgery, Shantou Central Hospital, Affiliated Shantou Hospital of Sun Yat-sen University, Shantou, Guangdong, China.
authors.forename: Jin-Hui
authors.initials: JH
authors.lastname: Shen
authors.affiliation: The Key Laboratory of Molecular Biology for High Cancer Incidence Coastal Chaoshan Area, Shantou University Medical College, Shantou, Guangdong, China; Institute of Oncologic Pathology, Shantou University Medical College, Shantou, Guangdong, China.
authors.forename: Xiu-E
authors.initials: XE
authors.lastname: Xu
authors.affiliation: Departments of Oncology Surgery, Shantou Central Hospital, Affiliated Shantou Hospital of Sun Yat-sen University, Shantou, Guangdong, China.
authors.forename: Jun-Hui
authors.initials: JH
authors.lastname: Fu
authors.affiliation: Departments of Oncology Surgery, Shantou Central Hospital, Affiliated Shantou Hospital of Sun Yat-sen University, Shantou, Guangdong, China.
authors.forename: Zhi-Yong
authors.initials: ZY
authors.lastname: Wu
authors.affiliation: The Key Laboratory of Molecular Biology for High Cancer Incidence Coastal Chaoshan Area, Shantou University Medical College, Shantou, Guangdong, China; Department of Biochemistry and Molecular Biology, Shantou University Medical College, Shantou, Guangdong, China.
authors.forename: En-Min
authors.initials: EM
authors.lastname: Li
authors.affiliation: The Key Laboratory of Molecular Biology for High Cancer Incidence Coastal Chaoshan Area, Shantou University Medical College, Shantou, Guangdong, China; Institute of Oncologic Pathology, Shantou University Medical College, Shantou, Guangdong, China.
authors.forename: Li-Yan
authors.initials: LY
authors.lastname: Xu
mesh_terms: D014408:Biomarkers, Tumor / Q000235:genetics; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology*; D002352:Carrier Proteins / Q000235:genetics; D002681:China; D066246:ErbB Receptors / Q000235:genetics; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology*; D000077277:Esophageal Squamous Cell Carcinoma; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D008297:Male; D008840:Microfilament Proteins / Q000235:genetics; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D011379:Prognosis; D016329:Sp1 Transcription Factor / Q000235:genetics; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor; D002352:Carrier Proteins; D008840:Microfilament Proteins; D016329:Sp1 Transcription Factor; C108209:SP1 protein, human; C020324:fascin; C512478:EGFR protein, human; D066246:ErbB Receptors