Predicting efficacy of esophageal squamous cell carcinoma patients based on fibroblast activation protein-α expression levels
Objective To investigate the prognostic significance of fibroblast activation protein-α(FAP-α)before treatment in patients with locally advanced inoperable esophageal squamous cell carcinoma(LA-ESCC).Methods The clinical data of 65 patients with LA-ESCC who were treated with concurrent chemoradiotherapy(CCRT)for the first time in Shandong Cancer Hospital from June 1,2018 to May 1,2020 were analyzed retrospectively.The expression of FAP-α in pathologi-cal biopsy specimens of patients before CCRT was detected by immunohistochemistry.There were 27 cases in the high ex-pression group and 38 cases in the low expression group,and their expressions were scored.The correlation between FAP-α expression in the tumor stroma and clinical factors was analyzed by using the chi-square test.Cox proportional hazard regression model was used for univariate and multivariate analysis.The survival curve was drawn by Kaplan-Meier method,and the survival rate between groups was compared by Log-rank test.Results The median PFS was 17.1 months(95％CI:13.98-20.29)in the high FAP-α expression group and 19.8 months(95％CI:18.01-21.53)in the low FAP-α expression group;The median OS was 21.7 months(95％CI:19.09-24.25)in the high expression group and 24.3 months(95％CI:23.60-25.00)in the low expression group.The 1-year and 3-year PFS rates of FAP-α high ex-pression group were 80.9％and 18.5％,and the OS rates were 96.3％and 18.7％,respectively;In the low expression group,the 1-year and 3-year PFS rates were 100.0％and 15.6％,and the OS rates were 100.0％and 33.6％,respec-tively.There were significant differences in PFS(x2=4.041,P=0.044)and OS(x2=4.330,P=0.037)between the two groups.Multivariate Cox analysis showed that high FAP-α expression[PFS:HR(95％CI)1.91(1.09-3.34),P=0.023;OS:HR(95％CI)2.13(1.12-4.08),P=0.022]and high tumor location[PFS:HR(95％CI)2.13(1.21-3.73),P=0.009;OS:HR(95％CI)2.20(1.14-4.27),P=0.020]were still independent prognostic risk factors for PFS and OS in LA-ESCC.Conclusion FAP-α may be an important regulatory factor for inoperable LA-ESCC patients and may provide new therapeutic targets for LA-ESCC.
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