Expression, regulation and clinical significance of bone morphogenetic protein 6 in esophageal squamous-cell carcinoma.

Bone morphogenetic proteins (BMPs) are multifunctional cytokines. BMP-6 is involved in early steps of keratinogenesis. Esophageal squamous-cell carcinoma often shows abnormal keratinization. The aim of this study was to examine the expression and regulation of BMP-6 in esophageal carcinoma and to determine the relationship of its expression with tumor characteristics and survival. Avidin-biotin-peroxidase staining was performed using paraffin-wax-embedded tumor specimens collected from 172 patients with esophageal squamous-cell carcinoma, who underwent potentially curative surgery. Expression of BMP-6 and EGF-receptor in the esophageal-squamous-cell-carcinoma cell line COLO-680N and the hypopharyngeal-squamous-cell-carcinoma cell line FaDu was assayed with specific RT-PCR. In standard cell-cultivation conditions, COLO-680N and FaDu cells showed distinct expression of BMP-6, whereas in serum-free conditions BMP-6 expression was hardly detectable. The addition of EGF or EGF-related growth factors could elevate BMP-6 mRNA content. Immunohistochemically, all 172 tumors exhibited cytoplasmic immunoreactivity for BMP-6. The content of BMP-6 protein was inversely correlated with tumor differentiation (p < 0.01). Univariate survival analysis revealed that 74 patients with tumors of low immunoreactivity had higher 2-year and 5-year survival rates (50.0%/27.7%) than 75 patients with tumors of high immunoreactive scores (33.3%/21.6%). (p < 0.05). We conclude that BMP-6 is expressed in esophageal squamous-cell carcinoma. EGF-receptor activation is crucial for regulation of BMP-6 expression. BMP-6 protein content is correlated with the grade of tumor-cell differentiation and may add to indications of poor prognosis. Copyright 1999 Wiley-Liss, Inc.