Clinical significance of vasculogenic mimicry, vascular endothelial cadherin and SOX4 in patients with esophageal squamous cell carcinoma

Background: Vasculogenic mimicry (VM) plays an important role in invasion and metastasis of malignant tumor. High expression of vascular endothelial cadherin (VE-canderin) in malignant tumor cells can promote the formation of VM. High expression of SOX4 (sex-determining region Y-related high-mobility group box 4) was found in esophageal squamous cell carcinoma (ESCC). It can promote the development of epithelial stromal transformation. Then, SOX4 can promote the formation of VM in ESCC. Methods: Paraffin-embedded specimens of ESCC (with complete clinicopathological data) and normal esophageal mucosa adjacent to carcinoma (> 5 cm) were collected from January to December 2013. CD34/PAS was used to detect VM. The expression of VE-cadherin and SOX4 was used by immunohistochemistry. The patients were followed up in detail (survival time and survival status). Results: SOX4, VM, and VE-cadherin were highly expressed in ESCC. Moreover, they were positively correlated. Survival analysis shows that the expressions of SOX4, VM, and VE-cadherin are associated with the patient's prognosis and can be independent prognostic factors for ESCC. Conclusions: Studies suggests that SOX4, which is highly expressed in ESCC, is involved in the formation of VM. The combined detection of SOX4, VE-cadherin and VM expression can be used as biomarkers for invasion and metastasis of ESCC. These three markers can be used as powerful prognostic factors in patients with ESCC.