The Expression And Clinical Significance Of Nectin-4 In Esophageal Cancer

Objectives:We aimed to detect the expression of Nectin-4 in esophageal cancer tissues and to explore the relationship between the expression of Nectin-4 and the clinicopathological characteristics as well as prognosis of esophageal cancer patients.Methods:Immunohistochemical staining was applied to detect the expression of Nectin-4 in 94 cases of esophageal cancer tissue as well as 78 normal tissues adjacent to cancer.The rank sum test was adopted to compare the expression of Nectin-4 in esophageal cancer and adjacent normal tissues.Chi-square test was adopted to compare different clinicopathologic characteristics between patients with different protein levels.Kaplan-Meier survival analysis and Log-rank test were adopted to evaluate the impacts of Nectin-4 on overall survival(Overall Survival,OS).Univariate and multivariate models were applied to identify prognostic factors.Results:The positive rate of high expression of Nectin-4 in esophageal cancer tissues(37.8%)was significantly higher than that in adjacent normal tissues,with a significant difference(P<0.001).Nectin-4 expression was associated with tumor size,and the positive expression rate was higher in patients with tumors larger than 4.5cm in diameter,with a significant difference(χ~2=6.385,P=0.012).In tumor invasion depth,the positive expression rate of T3+T4 was higher than that of T1+T2,with a significant difference(χ~2=5.822,P=0.016);Kaplan-Meier analysis showed that OS was significantly lower in Nectin-4 positive patients than in negative patients(P<0.05).The univariate Cox proportional hazards model showed tumor diameter greater than or equal to 4.5cm(HR=1.674,P=0.044),depth of invasion(HR=2.950,P=0.008),lymph node metastasis(HR=2.518,P=0.003),and high expression of Nectin-4(HR=1.704,P=0.039)were associated with worse prognosis,and the prognosis of males was worse than that of females(HR=2.618,P=0.008).The multivariate Cox proportional hazards model showed that Nectin-4(HR=1.795,P=0.035)was an independent prognostic factor for patients with esophageal cancer.Infiltration depth(HR=2.121,P=0.087)and lymph node metastasis(HR=1.689,P=0.086)may be independent prognostic factors in patients with esophageal cancer.Conclusions:Our findings suggest that Nectin-4 maybe play an important role in the occurrence and development of esophageal cancer.It can be used as an important risk factor for the prognosis evaluation of esophageal cancer patients and can be used as an important molecular target for the diagnosis and treatment of esophageal cancer.