The expression of Wnt/β-cantenin signaling pathway related protein in Kazak esophageal squamous cell carcinoma and its prognostic significance
Authors: Xu Shanshan , Li Chao , Zhou Yaxing , Wang Hui , Shi Yi , Zhang Wenjing , Ma Yuqing 
Published: March 2020

Abstract
Background Esophageal squamous cell carcinoma (ESCC) is one of the most common malignant tumors. Kazak in Xinjiang is a high incidence of esophageal cancer in China. It is known that the occurrence of ESCC is related to the abnormal activation of Wnt/β-cantenin signaling pathway, but the regulatory mechanism of its abnormal activation is not clear. This study aims to study the role of Wnt/β-cantenin signaling pathway related proteins in the development of Kazakh esophageal cancer.Methods: Methods In this study, 226 paraffin tissues and 29 fresh esophageal squamous carcinoma tissues were included. Immunohistochemistry and RT-PCR were used to detect Wnt/β-cantenin signaling pathway related proteins (Wnt2, β-cantenin, GSK3, The expression of suivivin in ESCC and its corresponding normal esophageal mucosa of Kazak and Han nationality, and the relationship between the expression of each protein and the clinicopathological characteristics and prognosis of Kazak ESCC were analyzed. Results We found that there was a significant difference between Han nationality and age (p = 0.038) and lymph node metastasis (p = 0.043). The proportion of Kazak patients under 60 years old was higher than that of Han nationality, indicating that the age of Kazak ESCC patients was lower; the proportion of Han nationality with lymph node metastasis was higher, indicating that the recurrence and progression rate was higher; the expression of Wnt2 in ESCC was related to TNM (p= 0.012), I = 9.8%, II = 52.9%, III = 29.4%, IV = 7.8%; the expression of β- Catenin was significantly different in the depth of invasion (p = 0.032), postoperative radiotherapy or chemotherapy (p = 0.049); the expression of GSK3β in ESCC was related to TNM (p = 0.013), in which I = 13.2%, II = 51.5%, III = 29.4%, IV = 5.9%.The mRNA expression of β- cantenin and GSK3β in ESCC was significantly higher than that in normal esophageal mucosa (p < 0.001), but there was no significant difference in Wnt2 and survivin. Lymph node metastasis (p=0.009), nerve invasion (p= 0.001) and radiotherapy and chemotherapy (p < 0.001) can be used as independent factors to affect the Overalll survivalof patients with ESCC; TNM (p= 0.017), nerve invasion (p= 0.028), hematogenous metastasis (p=0.048), radiotherapy and chemotherapy (p = 0.008) and Survivin (p = 0.0029) were all independent influence shadows of squamous cell carcinoma in patients with ESCC. There was no difference between Kazak and Han in Overalll survival(p = 0.929) and progression free survival (p = 0.845). Discussion In ESCC, the level of β-cantenin, protein in Wnt/β-cantenin signaling pathway is high, while that of GSK-3 is low. The recurrence time of survivin positive patients is shorter than that of negative patients. In addition, the expression of Wnt2,β-cantenin, GSK3βand Survivin were not significantly different between Han and Kazak, and there was no significant difference in the total and progression free survival of Kazak patients with ESCC.