A relationship between replication protein A and occurrence and prognosis of esophageal carcinoma

Esophageal carcinoma (EC) is an aggressive and the third most common cancer of the digestive tract with poor prognosis. Replication protein A (RPA) is critically required for DNA replication and its elevated expression has been observed in many malignant tumors. In this study, we investigated the expression of RPA1 and RPA2, subunits of RPA, and assessed their prognostic value in EC patients. We analyzed immunohistochemically the expression of RPA1 and RPA2 proteins in 48 EC resection specimens in relation with clinicopathological parameters and survival. We observed a significant elevated (P < 0.001) RPA1 and RPA2 expressions (labeling index) in the tumor than adjacent non-tumor tissues. In addition, both RPA1 and RPA2 labeling index in lymph node metastasis patients was significantly higher (both P = 0.000) than patients without lymph node metastasis. However, RPA1 and RPA2 labeling index in early stage was significantly lower (P = 0.000 and P = 0.002, respectively) than that of late stage EC patients. Importantly, patient's survival at early stage was significantly higher (P = 0.016) than late stage EC and lymph node metastasis and RPA1 expression was associated with adverse patient's outcome in multivariate analysis (P < 0.05 and P < 0.00, respectively). In conclusion, RPA1 could be a useful prognostic indicator in patients with esophageal carcinoma and might be a future attractive therapeutic target for regulation by tumor suppressors.