• Open Access

Clusterin as a predictor for chemoradiotherapy sensitivity and patient survival in esophageal squamous cell carcinoma

Authors

  • Li-Ru He,

    1. State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-Sen University, Guangzhou
    2. Department of Radiotherapy, Cancer Center, Sun Yat-Sen University, Guangzhou, China
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  • Meng-Zhong Liu,

    Corresponding author
    1. State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-Sen University, Guangzhou
    2. Department of Radiotherapy, Cancer Center, Sun Yat-Sen University, Guangzhou, China
      To whom correspondence should be addressed. E-mail: xied@mail.sysu.edu.cn; LMZ1955@163.com
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  • Bin-Kui Li,

    1. State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-Sen University, Guangzhou
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  • Hui-Lan Rao,

    1. State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-Sen University, Guangzhou
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  • Yi-Ji Liao,

    1. State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-Sen University, Guangzhou
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  • Lan-Jun Zhang,

    1. State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-Sen University, Guangzhou
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  • Xin-Yuan Guan,

    1. State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-Sen University, Guangzhou
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  • Yi-Xin Zeng,

    1. State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-Sen University, Guangzhou
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  • Dan Xie

    Corresponding author
    1. State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-Sen University, Guangzhou
      To whom correspondence should be addressed. E-mail: xied@mail.sysu.edu.cn; LMZ1955@163.com
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To whom correspondence should be addressed. E-mail: xied@mail.sysu.edu.cn; LMZ1955@163.com

Abstract

Clusterin (CLU) is frequently overexpressed and correlates closely with chemotherapy and radiotherapy resistance and poor prognosis in many human cancers. However, the significance of CLU expression in chemoradiotherapy (CRT) sensitivity and its effect on the prognosis of esophageal squamous cell carcinoma (ESCC) are still unknown. In the present study, we used the methods of immunohistochemistry and terminal deoxyuridine triphosphate nick-end labeling assay to examine the expression status of CLU and apoptotic index in 110 pretreated biopsy specimens of ESCC patients treated with definitive CRT. High expression of CLU was observed in 42.7% of epithelium and 50.0% of stroma in ESCC. A significant association of high CLU stromal expression with large tumor size (= 0.012) and locoregional progression (= 0.001) was observed, and high epithelial expression of CLU showed a significant correlation with the lack of complete response (= 0.028) and low apoptotic index (= 0.001). Univariate analysis revealed that high CLU stromal expression was associated with poor locoregional progression-free survival, distant progression-free survival, and overall survival. Furthermore, ESCC patients with high CLU expression in both epithelium and stroma have the shortest survival time among the subgroups of different CLU expression status. In multivariate analysis, CLU stromal expression was evaluated as an independent prognostic factor for locoregional progression-free survival, distant progression-free survival, and overall survival. These findings suggest an important role for CLU, especially in stroma, in ESCC progression, and that high CLU epithelial expression might be a promising predictor of ESCC resistance to CRT. (Cancer Sci 2009; 100: 2354–2360)

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