title: Coexpression of periostin and EGFR in patients with esophageal squamous cell carcinoma and their prognostic significance.
abstract: BACKGROUND
  Both periostin (PN) and epidermal growth factor receptor (EGFR) can predict the prognosis of several carcinomas alone. However, coexpression of PN and EGFR in esophageal squamous cell carcinoma (ESCC) still remains unknown. We aimed to clarify their relationship with clinicopathological factors and prognostic significance of their coexpression in ESCC.
  
  
  METHODS
  In this single-center retrospective study, immunohistochemistry was performed to evaluate the expression of PN and EGFR in ESCC and paracarcinomatous tissues of 83 patients. The quantitative expression levels of PN and EGFR were examined in two ESCC and tumor-adjacent tissues. The levels of PN and EGFR expression were correlated with clinicopathological parameters by the χ (2) or Kruskal-Wallis method. Spearman's rank correlation test was performed to determine the relationship between PN and EGFR expression levels. Kaplan-Meier and Cox regression analyses were used to detect the prognostic factors of disease-free survival (DFS) and overall survival (OS).
  
  
  RESULTS
  The high expression of PN protein in ESCC tissues was significantly associated with tumor length (P=0.044), differentiation grade (P=0.003), venous invasion (P=0.010), invasion depth (P=0.007), lymphatic metastasis (P=0.000), and tumor stage (P=0.000). The high expression of EGFR protein in ESCC tissues was only significantly related to lymphatic metastasis (P=0.000), invasion depth (P=0.022), and tumor stage (P=0.000). Kaplan-Meier analysis showed that high expression of PN was closely correlated to reduced OS (P=0.000) and DFS (P=0.000), which was consistent with EGFR expression. Cox regression analysis identified PN and EGFR as independent poor prognostic factors of OS and DFS in the ESCC patients (P<0.05). Moreover, the risk of death for the ESCC patients with low expression of two biomarkers and high expression of single biomarker was 0.243 times (P=0.000) and 0.503 times (P=0.030), respectively, than that for patients with high expression of two biomarkers.
  
  
  CONCLUSIONS
  PN and EGFR are related to miscellaneous clinicopathologic characteristics. Coexpression of PN and EGFR is more closely to be of predictive value on ESCC development and progression, which may offer a novel and potential target strategy for ESCC treatment in the future.
authors: Department of Medical Oncology.
authors: Wei
authors: W
authors: Jia
authors: Department of Medical Oncology.
authors: Wei
authors: W
authors: Wang
authors: Department of Medical Oncology.
authors: Chu-Shu
authors: CS
authors: Ji
authors: Department of Pathology, Anhui Provincial Hospital, Anhui Medical University, Hefei, People's Republic of China.
authors: Jun-Yang
authors: JY
authors: Niu
authors: Department of Medical Oncology.
authors: Ya-Jing
authors: YJ
authors: Lv
authors: Department of Pathology, Anhui Provincial Hospital, Anhui Medical University, Hefei, People's Republic of China.
authors: Hang-Cheng
authors: HC
authors: Zhou
authors: Department of Medical Oncology.
authors: Bing
authors: B
authors: Hu
keywords: epidermal growth factor receptor; esophageal squamous cell carcinoma; periostin; prognosis