%A Hang,Junbiao %A Du,Hailei %A Fangxiu,Luo %A Shi,Minmin %A Che,Jiaming %A Zhu,Lianggang %A Li,Hecheng %D 2021 %J Pathology and Oncology Research %C %F %G English %K Esophageal squamous cell carcinoma (ESCC),Autophagy,Apoptosis,Beclin-1,prognosis %Q %R 10.3389/pore.2021.594724 %W %L %M %P %7 %8 2021-April-09 %9 Original Research %+ Prof Junbiao Hang,Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine,Shanghai,China,drhangjb@hotmail.com %# %! A novel important cancer biomarker %* %< %T Beclin-1 is a Promising Prognostic Biomarker in a Specific Esophageal Squamous Cell Carcinoma Population %U https://www.por-journal.com/articles/10.3389/pore.2021.594724 %V 27 %0 JOURNAL ARTICLE %@ 1532-2807 %X The effects of autophagy and apoptosis in the prognostic assessment and treatment of Esophageal squamous cell carcinoma (ESCC) remain to be elucidated. Here, we conducted a retrospective study on the histopathology of ESCC, investigated the expression of Beclin-1 and Bcl-2 proteins (both autophagy- and apoptosis-related) in esophageal cancer tissue, and analyzed the significance of these proteins for the prognosis of ESCC. In the present study, the expression level of Beclin-1 in ESCC was significantly lower than that in adjacent tissues (p < 0.01), whereas the expression level of Bcl-2 showed the opposite pattern (p < 0.01). Furthermore, low expression of Beclin-1 was associated with more advanced ESCC stages and lymph node metastasis. However, high expression of Bcl-2 was associated with more advanced ESCC stages, deeper tumor invasion, and lymph node metastasis. Moreover, the relationship between Bcl-2 expression and OS was not significant (p > 0.05), whereas Beclin-1 expression was significantly associated with OS (p < 0.05). Subgroup analysis showed that Beclin-1 expression was significantly associated with OS in the high-Bcl-2-expression group but not in the low-Bcl-2-expression group. Importantly, Beclin-1 upregulation or downregulation significantly upregulated or downregulated invasion, respectively, in EC9706 cells in combination with high expression but not low expression of Bcl-2. These findings reveal that differences in autophagy and apoptotic states and their activities may promote malignant tumor differentiation, which could lead to a more aggressive esophageal squamous cell phenotype and a worse survival prognosis. Here, Beclin-1 was shown to be a promising prognostic biomarker and therapeutic target for patients with ESCC in the high-Bcl-2-expression population.