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Nrf2 is Useful for Predicting the Effect of Chemoradiation Therapy on Esophageal Squamous Cell Carcinoma

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The transcription factor NF-E2-related factor 2 (Nrf2) was originally identified to be a critical regulator of intracellular antioxidants and phase II detoxification enzymes. Recent studies have shown that high Nrf2 expression gives cancer cells an advantage for survival from anticancer chemotherapy and radiation therapy. The aims of this retrospective study were to examine the expression of Nrf2 in biopsy specimens of esophageal squamous cell carcinoma (ESCC) and to evaluate whether such expression is useful for predicting the response to chemoradiation therapy (CRT).

Methods

A total of 46 patients with ESCC who received curative surgery after CRT from 1997 to 2011 were enrolled in the current study. Nrf2 expression in the biopsy specimens before CRT was examined immunohistochemically using anti-Nrf2 antibody. The correlations between Nrf2 expression and clinical factors and histological and clinical response to CRT were analyzed.

Results

The rate of Nrf2-positive expression was 39 %. Both clinically and histologically, significant correlations were found between positive Nrf2 expression and unfavorable response to CRT. Furthermore, Nrf2 was significantly correlated with clinical lymph node metastases and patients’ postoperative outcomes. Multivariate analysis showed that Nrf2 expression status was an independent prognostic factor.

Conclusions

Nrf2 expression was found to be closely related to the effect of CRT and could predict the CRT outcome in patients with ESCC.

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Acknowledgment

This study is supported by a Grant in Aid for Scientists from the Ministry of Education, Culture, Sports, Science and Technology of Japan (Grant Number 10398282).

Disclosures

There are no financial disclosures from any authors.

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Authors and Affiliations

  1. Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical Sciences, Kagoshima University, Kagoshima, Japan

    Yota Kawasaki MD, Hiroshi Okumura MD, Yasuto Uchikado MD, Yoshiaki Kita MD, Ken Sasaki MD, Tetsuhiro Owaki MD, Sumiya Ishigami MD & Shoji Natsugoe MD

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  1. Yota Kawasaki MD
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  2. Hiroshi Okumura MD
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  3. Yasuto Uchikado MD
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  4. Yoshiaki Kita MD
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  5. Ken Sasaki MD
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  6. Tetsuhiro Owaki MD
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  7. Sumiya Ishigami MD
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  8. Shoji Natsugoe MD
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Correspondence to Hiroshi Okumura MD.

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Kawasaki, Y., Okumura, H., Uchikado, Y. et al. Nrf2 is Useful for Predicting the Effect of Chemoradiation Therapy on Esophageal Squamous Cell Carcinoma. Ann Surg Oncol 21, 2347–2352 (2014). https://doi.org/10.1245/s10434-014-3600-2

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  • DOI: https://doi.org/10.1245/s10434-014-3600-2

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