Tumor-infiltrating CD8+ T cell is prognostic and predicts adjuvant chemotherapy benefit in patients with limited-stage small cell esophageal carcinoma

NSE and ProGRP Are Promising Markers for Diagnosis, Efficacy Evaluation, Follow-Up Monitoring, and Prognosis of Small Cell Esophageal Carcinoma

BACKGROUND

To investigate the clinical implications of serum carcinoembryonic antigen (CEA), neuron specific enolase (NSE), and pro-gastrin-releasing peptide (ProGRP) in small cell esophageal carcinoma (SCEC).

METHODS

Receiver operating characteristic (ROC) curves were used to determine the area under the curve (AUC), sensitivity, and specificity of serum markers for differentiating SCEC from patients with esophageal squamous carcinoma (ESCC), esophageal adenocarcinoma (EAC) and healthy subjects.

RESULTS

The combination of ProGRP and NSE demonstrated significant diagnostic efficacy in distinguishing SCEC from ESCC, EAC, and healthy individuals. After treatment, serum levels of ProGRP, NSE, and CEA in SCEC patients with disease control decreased significantly compared to pre-treatment levels. Conversely, the serum levels of ProGRP and NSE in patients with disease progression after treatment were significantly increased compared to those before treatment. Compared with those in the follow-up phase, the levels of ProGRP, NSE, and CEA significantly increased after tumor progression in SCEC patients. This study further exhibited that serum levels of ProGRP above 45.15 pg/mL and NSE above 14.70 ng/mL during follow-up after first-line treatment in SCEC patients were associated with poor progression-free survival (PFS). Moreover, significant associations were observed between baseline serum concentrations of ProGRP, NSE, CEA and both PFS and cancer-specific survival (CSS) in SCEC patients.

CONCLUSIONS

ProGRP and NSE have significant value in the diagnosis and differential diagnosis of SCEC, and are also associated with the clinical stage and prognosis of SCEC patients, as well as are effective indicators for evaluating therapeutic efficacy and disease recurrence.

A tumor immune microenvironment-related integrated signature can predict the pathological response and prognosis of esophageal squamous cell carcinoma following neoadjuvant chemoradiotherapy: A multicenter study in China

BACKGROUND

Currently, there are insufficient indicators for the reliable assessment of treatment response following neoadjuvant chemoradiotherapy (nCRT) in patients with esophageal squamous cell carcinoma (ESCC). Considering the essential role of protein-coding and non-coding RNAs in gene regulation and cellular processes, we systematically explored the molecular features and clinical significance of mRNA and lncRNA in 249 pretreatment biopsies from four hospitals in three districts with a high incidence of ESCC patients in China.

METHODS

During the discovery phrase, 13 differentially expressed genes were identified and validated between samples with a complete pathological response (pCR) and those with an incomplete pathological response (<pCR). Subsequently, we constructed a predictive mRNA and lncRNA signature (SERPINE1, LINC00592, and PRKAG2-AS1) using Fisher's linear discriminant analysis (FLDA) with stepwise variant-selection, followed by validation of its predictive ability in both internal and external cohorts.

RESULTS

Our signature showed great value in predicting the response to nCRT among ESCC samples and acted as an independent predictive indicator, in addition to demonstrating great potential in estimating patient prognosis. Interestingly, we found that patients with a high signature score had lower PD-L1 and IDO1 expression levels but higher CD8⁺ T cells infiltration, suggesting that PD-L1 and IDO1 are negatively correlated with a high signature score and further associated with pCR and a better prognosis.

CONCLUSION

The present study identified a promising three-gene-based predictive signature that has powerful clinical implications for the identification of pCR and a good prognosis among patients with ESCC. Further immune-related exploration may provide an opportunity for future therapeutic combination.