CD71 in Tandem With Ki-67 and p53: Unraveling Their Prognostic and Diagnostic Significance in Esophageal Squamous Cell Carcinoma and Precursor Lesions.

Background: Esophageal squamous cell carcinoma (ESCC), a commonly diagnosed cancer, poses challenges for early detection due to differentiation difficulties.

Aims: To assess the diagnostic and prognostic value of CD71, Ki-67, and p53 in ESCC, intraepithelial neoplasia (IEN), and esophageal squamous simple hyperplasia (ESSH).

Methods: We evaluated the diagnostic and prognostic performance of CD71, Ki-67, and p53 in 162 esophageal tissue samples (44 ESSH, 55 IEN, and 63 ESCC) using immunohistochemistry. Multivariate logistic regression model was used to train and validate, and ROC curve analysis was assessed diagnostic accuracy. Prognostic significance was evaluated using Kaplan-Meier survival analysis and Cox regression models.

Results: Notably, CD71 positivity showed a stepwise increase across the progression of ESCC: 0% (0/44) in ESSH, 36.4% (20/55) in IEN, and 61.9% (39/63) in ESCC. The CD71-Ki-67-p53 panel demonstrated superior diagnostic precision (ESCC vs. ESSH: training AUC=0.996, test AUC=0.932) compared with Ki-67-p53 alone. In the context of esophageal cancer, low expression of CD71, Ki-67, or p53 was significantly associated with improved clinical outcomes (P<0.05). The CD71-Ki-67-p53 panel effectively stratified patients into high- and low-risk groups (P=0.004). Multivariate Cox regression confirmed the independent prognostic value of CD71-Ki-67-p53 panel (HR=0.064, P=0.013), after controlling for clinicopathological variables.

Conclusion: The CD71-Ki-67-p53 immunohistochemical panel enhances diagnostic accuracy and prognostic stratification in esophageal lesions, offering a clinically valuable tool for early detection and personalized management. Further validation in larger cohorts is warranted to confirm its association with cancer progression and prognosis.