Association of the primary tumor's SUVmax with survival after surgery for clinical stage IA esophageal cancer: a single-center retrospective study

Identification of KHSRP-Regulated RNAs in Esophageal Cancer by Integrated Bioinformatics Analysis

Background: The objective of this study was to identify key molecules that included long noncoding RNAs (lncRNAs), microRNAs (miRNAs), and mRNAs involved in esophageal cancer with KH-type splicing regulatory protein (KHSRP) knockdown. Materials and Methods: GSE99422 and GSE99423 from Gene Expression Omnibus database were extracted. After differentially expressed analysis of miRNAs, lncRNAs, and mRNAs, the lncRNAs-mRNAs interaction was obtained. Then the protein-protein interaction (PPI) network and module analyses were performed for differentially expressed mRNAs (DEmRNAs). Combined with miRWalk tool and DIANA-LncBase tool, regulating relationship between differentially expressed miRNAs (DEmiRNAs) and DEmRNAs/DElncRNAs were predicted. Finally, mRNA-miRNA-lncRNA regulatory network construction was established by Cytoscape software. Finally, the key genes were validated based on the Gene Expression Profiling Interactive Analysis (GEPIA) database. Results: Totally, 2,027 DEmiRNAs, 3,480 DElncRNAs, and 18,293 DEmRNAs were screened. The PPI network included 399 nodes and 1671 interaction pairs, and two function models (Cluster 1 and Cluster 2) were separately identified. The PLK1 was a hub in the Cluster 1, which mainly enriched in the function of nuclear division. Then the competing endogenous RNA (ceRNA) network was constructed with 20 miRNAs, 66 lncRNA, and 202 mRNA. Here, lncRNA RP11-159D12.2 might function as a ceRNA in regulating BIRC5 expression of esophagus cancer through competitively binding to hsa-miR-4430. BIRC5 was mainly enriched in the function of mitotic nuclear division. Besides, the expression of BIRC5 and PLK1 genes was upregulated in tumor tissues compared with normal controls. Also, the correlation analysis showed that the key genes (BIRC5 and PLK1) were validated to be positively correlated with KHSRP. Conclusions: PLK1, BIRC5, hsa-miR-4430, and lncRNA RP11-159D12.2 were likely to be associated with esophageal cancer development.

The role of primary tumor SUVmax in the diagnosis of invasion depth: a step toward clinical T2N0 esophageal cancer

Background

The controversy regarding optimal clinical T2N0 esophageal cancer treatment ultimately stems from the clinical staging modalities’ inaccuracy. Because most inaccuracies lie in clinical T2 to pathological T1, it is vital to discriminate whether the muscularis propria is invaded.

Methods

We investigated the association between the primary tumor maximal standard uptake value (SUVmax), and the pathological features and overall survival. We attempted to construct a discriminative model through logistic regression analysis.

Results

A total of 140 cN0 esophageal squamous cell carcinoma (ESCC) patients were enrolled. Primary tumor SUVmax differed significantly in paired pathological T categories (P<0.05), but not pT2 vs. pT3 (P=0.648). Age (≤65 vs. >65), biopsy differentiation grades (well or moderately vs. poorly vs. unknown), and primary tumor SUVmax (continuous) were independent risk factors for invasion depth. Subsequently, the age categories, the biopsy differentiation grade categories, and the primary tumor SUVmax categories (≤7.4 vs. >7.4) were included in the logistic regression analysis to construct a discriminative model, showing a good performance in discriminating pT2–3 vs. pT1 in terms of accuracy 87.1%, sensitivity 93.6%, specificity 73.9%, and area under the curve (AUC) 0.887 [95% confidence interval (CI): 0.822 to 0.951]. Of these factors, biopsy differentiation grades and primary tumor SUVmax showed significant differences in overall survival (P<0.05), while the age categories did not.

Conclusions

The novel baseline model comprised of age, biopsy differentiation grades, and primary tumor SUVmax provide much discriminative performance in determining whether the muscularis propria is invaded. Further studies are necessary to validate the findings and guide clinical practice for cT2N0 esophageal cancer.