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The prognostic significance of Smad3, Smad4, Smad3 phosphoisoform expression in esophageal squamous cell carcinoma.
[esophageal squamous cell carcinoma]
Smad
3
functions
as
an
integrator
of
diverse
signaling
,
including
transforming
growth
factor
β
signaling
and
the
function
of
Smad
3
is
complexly
regulated
by
differential
phosphorylation
at
various
sites
of
Smad
3
.
Despite
the
importance
of
Smad
3
and
its
various
phosphoisoforms
,
their
prognostic
significance
has
rarely
been
studied
.
In
this
study
,
we
demonstrated
the
prognostic
significance
of
Smad
3
,
its
phosphoisoforms
,
and
Smad
4
expression
by
immunohistochemistry
in
126
esophageal
squamous
cell
carcinomas
.
The
phosphoisoforms
of
Smad
3
studied
in
this
article
included
phosphorylation
at
C-
terminal
(
pSmad
3
C
)
(
Ser
(
423
/
425
)
)
and
phosphorylation
at
the
linker
region
(
pSmad
3
L
)
(
Ser
(
213
)
)
.
High
expression
of
Smad
3
was
associated
with
shorter
overall
survival
.
Co
-existence
of
high
expression
of
pSmad
3
L
(
S
213
)
and
low
expression
of
pSmad
3
C
(
S
423
/
425
)
were
associated
with
advanced
N
stage
and
an
independent
prognostic
factor
for
overall
[
hazard
ratio
(
HR
)
2
.
03
,
95
%
confidence
interval
(
CI
)
(
1
.
10
-
3
.
75
)
,
p
=
0
.
023
]
and
disease-free
survival
[
HR
2
.
41
,
95
%
CI
(
1
.
32
-
4
.
39
)
,
p
=
0
.
004
]
.
In
conclusion
,
co
-existence
of
high
pSmad
3
L
(
Ser
(
213
)
)
expression
and
low
pSmad
3
C
(
Ser
(
423
/
425
)
)
expression
can
be
considered
as
immunohistochemical
biomarkers
for
predicting
prognosis
as
well
as
future
therapeutic
targets
.
In
addition
,
our
results
of
combinatory
effect
of
differential
phosphorylation
of
Smad
3
on
prognosis
suggest
the
mode
of
action
of
Smad
3
might
be
logically
determined
by
its
phosphorylation
pattern
.
Diseases
Validation
Diseases presenting
"growth factor β"
symptom
esophageal squamous cell carcinoma
hirschsprung disease
inclusion body myositis
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