Abstract:

Objective To investigate the predictive value of tumor necrosis factor receptor-associated factor 6 (TRAF6) expression in the efficacy of radiotherapy for patients with esophageal squamous cell carcinoma (ESCC). Methods A total of 278 patients with ESCC received radical radiotherapy in Yixing Cancer Hospital of Jiangsu Province from February 2012 to March 2015 were included. The expression of TRAF6 in esophageal cancer tissue was detected by immunohistochemistry. The correlations between the expression of TRAF6 and clinicopathological features, short-term efficacy of radiotherapy and survival of ESCC patients were investigated. Results All the patients were divided into positive expression group (n=194) and negative expression group (n=84). TRAF6 expression was significantly associated with TNM stage and lymph node metastasis in ESCC patients (χ²=13.670, P<0.001; χ²=45.497, P<0.001). The total effective rate of radiotherapy in the TRAF6 positive expression group was 62.9% (122/194), which was significantly lower than that of TRAF6 negative expression group (92.9%, 78/84), and the difference was statistically significant (χ²=26.085, P<0.001). The median survival time of TRAF positive expression group was 51 months, while that of TRAF negative expression group was not reached, and the difference of survival curve between the two groups was statistically significant (χ²=7.952, P=0.005). Further analysis showed that higher TNM stage, lymph node metastasis and positive expression of TRAF6 increased the risk of death in ESCC patients (HR=1.96, 95%CI: 1.39-2.76; HR=1.72, 95%CI: 1.29-2.29; HR=2.31, 95%CI: 1.57-3.39). Conclusion Patients with TRAF6 positive expression of ESCC have low radiotherapy sensitivity. TRAF6 may be a new target for diagnosis and treatment of ESCC patients, which provides a new idea for the diagnosis, treatment and prognosis of ESCC.

Key words: Esophageal neoplasms, Radiotherapy, Radiation tolerance, Tumor necrosis factor receptor-associated factor 6