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High Expression of Cathepsin E in Tissues but Not Blood of Patients with Barrett's Esophagus and Adenocarcinoma.
[esophageal adenocarcinoma]
Cathepsin
E
(
CTSE
)
,
an
aspartic
proteinase
,
is
differentially
expressed
in
the
metaplasia-dysplasia-
neoplasia
sequence
of
gastric
and
colon
cancer
.
We
evaluated
CTSE
in
Barrett
's
esophagus
(
BE
)
and
cancer
because
increased
CTSE
levels
are
linked
to
improved
survival
in
several
cancers
,
and
other
cathepsins
are
up-regulated
in
BE
and
esophageal
adenocarcinoma
(
EAC
)
.
A
total
of
273
pretreatment
tissues
from
199
patients
were
analyzed
[
31
normal
squamous
esophagus
(
NE
)
,
29
BE
intestinal
metaplasia
,
31
BE
with
dysplasia
(
BE
/
D
)
,
108
EAC
]
.
CTSE
relative
mRNA
expression
was
measured
by
real-time
polymerase
chain
reaction
,
and
protein
expression
was
measured
by
immunohistochemistry
.
CTSE
serum
levels
were
determined
by
enzyme-linked
immunosorbent
assay
.
Median
CTSE
mRNA
expression
levels
were
≥
1
,
000
-
fold
higher
in
BE
/
intestinal
metaplasia
and
BE
/
D
compared
to
NE
.
CTSE
levels
were
significantly
lower
in
EAC
compared
to
BE
/
intestinal
metaplasia
and
BE
/
D
,
but
significantly
higher
than
NE
levels
.
A
similar
expression
pattern
was
present
in
immunohistochemistry
,
with
absent
staining
in
NE
,
intense
staining
in
intestinal
metaplasia
and
dysplasia
,
and
less
intense
EAC
staining
.
CTSE
serum
analysis
did
not
discriminate
patient
groups
.
In
a
Â
uni-
and
multivariable
Cox
proportional
hazards
model
,
CTSE
expression
was
not
significantly
associated
with
survival
in
patients
with
EAC
,
although
CTSE
expression
above
the
25
th
percentile
was
associated
with
a
41
Â
%
relative
risk
reduction
for
death
(
hazard
ratio
0
.
59
,
95
Â
%
confidence
interval
0
.
27
-
1
.
26
,
p
Â
=
Â
0
.
17
)
.
CTSE
mRNA
expression
is
up-regulated
more
than
any
known
gene
in
Barrett
intestinal
metaplasia
and
dysplasia
tissues
.
Protein
expression
is
similarly
highly
intense
in
intestinal
metaplasia
and
dysplasia
tissues
.
Diseases
Validation
Diseases presenting
"intestinal metaplasia"
symptom
carcinoma of the gallbladder
esophageal adenocarcinoma
esophageal squamous cell carcinoma
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