Abstract
ObjectiveTo establish a relationship between esophageal squamous cell diseases and the expression of human telomerase reverse transcriptase (hTERT) and Eyes absent 4 (EYA4) mRNA in peripheral blood mononuclear cells.MethodsSubjects were 50 patients with esophageal squamous cell carcinoma (ESCC), 50 with dysplasia (ESCD), 50 with basal cell hyperplasia (BCH) and 50 controls. All subjects were residents of Feicheng County, Shandong Province, China , diagnosed by histopathology. Expression of hTERT and EYA4 mRNA in peripheral blood was determined by semiquantitative reverse transcription-polymerase chain reaction (RT-PCR).ResultsThe hTERT and EYA4 mRNA positive expression increased according to disease severity. At the cut-off value of ≥ 0.2, the positive expression rates of EYA4 were 14% for controls, 20.0% for BCH, 26% for ESCD and 52% for ESCC, respectively. At the cut-off value of ≥ 0.8, the positive expression rates of hTERT in the four groups were 24%, 30.0%, 52% and 80%, respectively. Using a positive value of 0.47 for EYA4, the testing sensitivities in the ESCD and ESCC groups were 4% and 16%, respectively, and the testing specificity increased to 100%. Using a positive value of 1.0 for hTERT, the testing sensitivities in the ESCD and ESCC groups were 48% and 60%, respectively, and the testing specificity increased to 72%. The testing sensitivities in the predicting ESCD and ESCC in the discriminant model including EYA4 and hTERT and the five traditional risk factors (sex, age, smoking, alcohol drinking, and family history of esophageal cancer) were 70% and 80%, and testing specificities were 76% and 88% respectively. However, the testing sensitivities and specificities in the predicting ESCD and ESCC in the model only including the above five traditional risk factors were lower than that in the former case.ConclusionEYA4 and hTERT mRNA expression increased with the severity of esophageal pathological changes and may be useful for identifying high-risk endoscopy candidates or for monitoring changes in premalignant esophageal lesions.
Highlights
Cancer cells release protein markers into the peripheral blood, but these are difficult to detect in the serum at the early stage of cancer
Subjects The subjects consisted of 50 patients diagnosed with esophageal squamous cell carcinoma (ESCC) (12 in situ and 38 invasive carcinomas), 50 cases with esophageal squamous cell dysplasia (ESCD), 50 cases with basal cell hyperplasia (BCH), and 50 controls in the endoscopic screening program from January 2004 to December 2006 in Feicheng county, China
The feasibility of prediction of high-risk persons As shown in Table 4, using ratios of Eyes absent 4 (EYA4) mRNA expression to β-actin with a positive cut-off value of 0.47, testing sensitivities in ESCD and ESCC became 4% and 16%, respectively, and the testing specificity increased to 100%, where no false positive samples were existed in the study
Summary
Cancer cells release protein markers into the peripheral blood, but these are difficult to detect in the serum at the early stage of cancer. It is possible that tumor markers will show up in mononuclear cells before they themselves could be detected in the circulation. The human telomerase reverse transcriptase (hTERT gene) mRNA expression is the most general molecular marker for the identification of human cancer and can be detected in 85% of all tumors, whereas most healthy tissues exhibit little or no expression [1,2,3,4]. Differential hTERT expression between tumor tissues and healthy tissues makes this gene a promising marker for the detection of tumor cells [6,7]
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