The Role of CDKN۲A Gene Expression in Patients Candidates for Esophagectomy: systematic review

Background: Esophageal cancer is a highly aggressive malignancy with poor prognosis, and identifying biomarkers for prognosis and treatment response is crucial. The CDKN۲A gene, known for its role in cell cycle regulation, has been implicated in esophageal cancer progression. This systematic review aims to evaluate the role of CDKN۲A gene expression in predicting clinical outcomes and treatment response in patients undergoing esophagectomy.Methods: A total of ۷ studies were included in this review, encompassing ۱,۲۹۰ patients with esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC). CDKN۲A expression was measured using immunohistochemistry, polymerase chain reaction, and next-generation sequencing. Clinical outcomes, including overall survival (OS), progression-free survival (PFS), and recurrence-free survival (RFS), were analyzed in relation to CDKN۲A status.Results: CDKN۲A loss was observed in ۴۰-۶۰% of tumors, with patients showing CDKN۲A loss experiencing significantly shorter OS, PFS, and RFS. Furthermore, CDKN۲A loss correlated with poorer responses to neoadjuvant therapies.Conclusion: CDKN۲A loss serves as a prognostic biomarker for poor survival outcomes and resistance to neoadjuvant therapies in esophageal cancer patients. Its role in treatment resistance highlights the potential for personalized treatment strategies targeting CDKN۲A alterations.

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Keywords: CDKN۲A ، Esophageal Cancer ، Prognosis ، neoadjuvant therapy ، Esophagectomy