Publication date: Available online 11 August 2018
Source: Auris Nasus Larynx
Author(s): Ching-Feng Lien, Tzer-Zen Hwang, Tsun-Mei Lin, Kai-Wen Liu, Bor-Shyh Lin, Chih-Chun Wang, Chuan-Chien Yang, Shyh-An Yeh
Abstract
Objective
Hypopharyngeal carcinoma has a very poor prognosis. The high incidence of second esophageal neoplasia is one of the major causes. To establish an efficient follow-up scheme for increasing the diagnostic yield and reducing the adverse impact of second esophageal neoplasia on survival, the purpose of this study was to explore a biomarker to predict second esophageal neoplasia.
Methods
In this retrospective cohort study, consecutive tissue specimens from those patients who underwent tumor resection between September 2007 and October 2015 were collected. Gene amplification was performed by real-time PCR. The expression of cortactin was evaluated by immunohistochemistry. The predictive risk factors of developing second esophageal neoplasia and prognostic factors related to survival were analyzed.
Results
A total of 187 patients were included with a mean follow-up of 48 months (12–118 months). Second esophageal tumors were found in 53 (28.3%), including 41 (21.9%) esophageal squamous cell carcinoma and 12 severe dysplasia. The results of multivariate analyses revealed that age (OR 2.81, 95% CI 1.16–6.78), cortactin overexpression (OR 2.49, 95% CI 1.17–5.33), and stage IV versus I (OR 6.49, 95% CI 1.68–25.18) were independent predictors of second esophageal neoplasia, and second esophageal neoplasia (HR 1.78, 95% CI 1.05–3.01) was an independent predictor of overall survival.
Conclusion
This is the first report to identify a potential biomarker for predicting second esophageal neoplasia in patients with hypopharyngeal carcinoma. In those patients with cortactin overexpression and younger age (≤60 years old), close surveillance for second esophageal neoplasia is required. In addition, the real effect of cortactin overexpression on development of primary esophageal carcinoma is required to be validated in a large cohort study.
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