Abstract
Purpose: Esophageal cancer is the sixth leading cause of cancer-related death worldwide, and is associated with a poor prognosis. Stromal tumor infiltrating lymphocytes (sTIL) and certain single nucleotide polymorphisms (SNPs) have been found to be predictive of patient survival. In this study, we explored the association between SNPs and sTIL regarding the predictability of disease-free survival in patients with esophageal squamous cell carcinoma (ESCC).Materials and methods: We collected 969 pathologically confirmed ESCC patients from 2010 to 2013 and genotyped 101 SNPs from 59 genes. The number of sTIL for each patient was determined using an automatic algorithm. A Kruskal-Wallis test was used to determine the association between genotype and sTIL. The genotypes and clinical factors related to survival were analyzed using a Kaplan-Meier curve, Cox proportional hazards model, and log-rank test.Results: The median age of the patients was 67 (42-85 years), there was a median follow-up of 851.5 days and 586 patients died. The univariable analysis showed that 10 of the 101 SNPs were associated with sTIL. Six SNPs were also associated with disease-free survival. A multivariable analysis revealed that sTIL, rs1801131, rs25487, and rs8030672 were independent prognostic markers for ESCC patients. The model combining SNPs, clinical characteristics and sTIL outperformed the model with clinical characteristics alone for predicting outcomes in ESCC patients.Conclusion: We discovered 10 SNPs associated with sTIL in ESCC and we built a model of sTIL, SNPs and clinical characteristics with improved prediction of survival in ESCC patients.
Highlights
Esophageal cancer (EC) is the seventh most common malignant neoplasm and ranks sixth among cancerrelated deaths worldwide [1]
We aimed to investigate the relationship between single nucleotide polymorphisms (SNPs) and automatically quantified Stromal tumor infiltrating lymphocytes (sTIL), we sought to explore their impact on the prognosis of esophageal squamous cell carcinoma (ESCC) in Taixing, China, a medium sized city in eastern China, with the highest incidence rate of ESCC
This study aimed to investigate the association between sTIL and SNPs, and to explore their prognostic value independent of the classical clinical variables of patients with ESCC
Summary
Esophageal cancer (EC) is the seventh most common malignant neoplasm and ranks sixth among cancerrelated deaths worldwide [1]. Eastern Asia has the highest incidence rate of EC [1]. EC can be divided into esophageal squamous cell carcinoma (ESCC) and adenocarcinoma based on histopathological classification, with ESCC accounting for about 90% of EC cases [2]. Since it is associated with mild symptoms, ESCC is often diagnosed only after the disease has progressed to a late stage, often meaning that the tumor cannot be resected or cured [3]. The five-year survival rate in developed countries is less than 20% [3, 4]. The main factors affecting the prognosis of ESCC include the treatment method, genetic markers, and the general health of the patient
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