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Updated: Apr 27, 2026
Development of Compendium for Esophageal Squamous Cell Carcinoma
Published on: April 12, 2024
Prognostic impact of renin-angiotensin system blockade in esophageal squamous cell carcinoma
Yen-Hao Chen1, Cheng-Hua Huang1, Hung-I Lu2
1Department of Hematology-Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Introduction:
The aim of this study is to evaluate whether the administration of renin-angiotensin system (RAS) inhibitors, angiotensin-I converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs), is associated with treatment outcome in patients with esophageal squamous cell carcinoma.
Materials And Methods:
A total of 141 esophageal squamous cell carcinoma patients receiving esophagectomy were identified, and were divided into two groups: an ACEI/ARB group (n=20), and a non-ACEI/ARB group (n=121). The effect of ACEIs or ARBs on cell proliferation and vascular endothelial growth factor (VEGF) secretion of esophageal squamous cell carcinoma cell lines, CE81T/VGH and TE2, were investigated by 3-(4.5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay and Enzyme-linked immunosorbent assay (ELISA), respectively.
Results:
Use of ACEI/ARB (p=0.032), pathologic T stage (p<0.001), pathologic N stage (p=0.012), tumor stage (p=0.006), and tumor location (p=0.032) were significantly associated with superior overall survival. In multivariate comparison, use of ACEI/ARB (p=0.006), tumor stage (p=0.002), and tumor location (p=0.014) represented the independent prognosticators of superior overall survival. In cell lines, ACEIs/ARBs inhibit cell proliferation and VEGF secretion in a dose-dependent manner.
Conclusions:
ACEIs/ARBs administration is independently associated with superior overall survival in patients with esophageal squamous cell carcinoma receiving esophagectomy. Our data support further investigation of the role of RAS inhibitors as a potential therapy in esophageal squamous cell carcinoma.
Insights
Renin-angiotensin system (RAS) inhibitors, including angiotensin-I converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs), are linked to better survival in esophageal squamous cell carcinoma patients. These drugs also inhibit cancer cell growth and vascular endothelial growth factor (VEGF) secretion in vitro.
Area of Science:
- Oncology
- Pharmacology
- Gastroenterology
Background:
- Esophageal squamous cell carcinoma (ESCC) is a significant global health concern.
- The role of renin-angiotensin system (RAS) inhibitors in cancer treatment outcomes is an area of ongoing research.
Purpose of the Study:
- To investigate the association between RAS inhibitor use (ACEIs/ARBs) and treatment outcomes in ESCC patients undergoing esophagectomy.
- To evaluate the in vitro effects of ACEIs/ARBs on ESCC cell proliferation and VEGF secretion.
Main Methods:
- Retrospective analysis of 141 ESCC patients, comparing outcomes between ACEI/ARB users (n=20) and non-users (n=121).
- In vitro studies using ESCC cell lines (CE81T/VGH, TE2) to assess proliferation (MTT assay) and VEGF secretion (ELISA) under ACEI/ARB treatment.
Main Results:
- ACEI/ARB use was significantly associated with superior overall survival (p=0.032) and was an independent prognosticator in multivariate analysis (p=0.006).
- ACEIs/ARBs demonstrated a dose-dependent inhibition of ESCC cell proliferation and VEGF secretion in vitro.
Conclusions:
- Administration of ACEIs/ARBs is independently associated with improved overall survival in ESCC patients post-esophagectomy.
- RAS inhibitors show potential as an adjunct therapy for ESCC, warranting further investigation.
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