Association of serum thrombospondin-1 and microRNA-21 expression with clinicopathological features and prognosis in esophageal squamous cell carcinoma

ZHANG Chongyang; YAO Juan

doi:10.3969/j.issn.1009-0460.2025.10.009

Abstract：Objective To explore the clinical significance of serum thrombospondin-1(TSP-1)and microRNA-21(miR-21)expression levels and their relationship with survival outcomes in patients with esophageal squamous cell carcinoma(ESCC).Methods Serum samples were collected from 100 patients with pathologically confirmed ESCC after treatment at Huai'an Hospital between January 2020 and December 2022.Serum TSP-1 levels were measured using enzyme-linked immunosorbent assay,and miR-21 expression was detected by real-time quantitative PCR.Patients were stratified into high and low expression groups based on the median expression levels of serum TSP-1 and miR-21.The correlation between the expression of these biomarkers and clinicopathological features was analyzed.Kaplan-Meier method with Log-rank test was used to compare overall survival(OS)between groups,and Cox proportional hazards regression model was applied to evaluate prognostic factors.Results The serum levels of TSP-1 and miR-21 in 100 ESCC patients were(103.32±14.26)ng/mL and 16.60±2.52,respectively.Based on the median expression levels(TSP-1:103.3 ng/mL;miR-21:16.6),patients were divided into high-and low-expression groups.The TSP-1 level in the high-expression group(117.53±11.02)ng/mL was significantly higher than that in the low-expression group(89.10±10.36)ng/mL(t=13.104,P<0.001).Similarly,the miR-21 level in the high-expression group(18.92±1.17)was significantly higher than that in the low-expression group(14.27±1.57)(t=17.274,P<0.001),and a negative correlation was observed between the two markers(r=-0.202,P=0.048).In terms of clinicopathological features,except for a significant association between miR-21 expression and gender(P<0.001),no notable correlations were found between the two markers and age,TNM stage,lymph node metastasis,or depth of invasion.Survival analysis revealed that the median OS in the high TSP-1 expression group was 32.6 months,which was significantly longer than the 27.1 months in the low-expression group(P<0.05).In contrast,the median OS in the high miR-21 expression group was 27.5 months,significantly shorter than the 33.6 months in the low-expression group(P<0.05).Multivariate analysis further confirmed that high TSP-1 expression was a protective factor for OS(HR=0.342,95%CI:0.193-0.606),while high miR-21 expression(HR=1.754,95%CI:1.039-2.963),lymph node metastasis,and TNM stage Ⅲ-Ⅳ were identified as risk factors.Conclusion In ESCC,serum TSP-1 as a protective factor shows a negative correlation with miR-21 as a risk factor.Both have potential prognostic value,and the efficacy of their combined application requires further validation in future studies.