Predicting malignant transformation of esophageal squamous cell lesions by combined biomarkers in an endoscopic screening program

Table 2 Distribution of p53, CA19-9 and carcinoembryonic antigen expression in the five groups¹n (%)

Protein expression	ESCC	HGD	LGD	BCH	Normal control
p53
Negative	63 (47.0)	24 (47.1)	159 (64.4)	56 (72.7)	64 (80.0)
Positive
1%-10%	18 (13.4)	17 (33.3)	62 (25.1)	17 (22.1)	11 (13.8)
10%-25%	20 (14.9)	8 (15.7)	20 (8.1)	3 (3.9)	5 (6.3)
25%-50%	24 (17.9)	2 (3.9)	6 (2.4)	1 (1.3)	0 (0)
≥ 50%	9 (6.8)	0 (0)	0 (0)	0 (0)	0 (0)
CA19-9
Negative	75 (56.0)	34 (66.7)	206 (83.5)	70 (90.8)	75 (93.8)
Positive
1%-10%	43 (32.1)	15 (29.4)	40 (16.1)	6 (7.9)	4 (5.0)
10%-25%	13 (9.7)	1 (2.0)	1 (0.4)	0 (0)	1 (1.3)
≥ 25%	3 (2.2)	1 (2.0)	0 (0)	1 (1.3)	0 (0)
CEA
Negative	34 (25.4)	20 (39.2)	189 (76.7)	59 (76.3)	67 (83.8)
Positive
1%-10%	47 (35.1)	27 (52.9)	56 (22.5)	16 (21.1)	7 (8.8)
10%-25%	31 (23.2)	4 (7.8)	2 (0.8)	1 (1.3)	6 (7.5)
25%-50%	19 (14.2)	0 (0)	0 (0)	1 (1.3)	0 (0)
≥ 50%	3 (2.2)	0 (0)	0 (0)	0 (0)	0 (0)
Three biomarkers combined2
Negative	21 (15.7)	12 (23.5)	129 (52.4)	44 (57.1)	58 (72.5)
Positive
1%-10%	35 (26.1)	26 (51.0)	90 (36.4)	28 (36.4)	13 (16.3)
10%-25%	30 (22.4)	10 (19.6)	22 (8.8)	4 (5.2)	9 (11.3)
25%-50%	36 (26.8)	3 (5.9)	6 (2.4)	1 (1.3)	0 (0)
≥ 50%	12 (9.0)	0 (0)	0 (0)	0 (0)	0 (0)

¹In the five groups, the Kruskal-Wallis H test values of the differences in positive protein expression ratios of p53, CA19-9, CEA, and the three biomarkers combined were 50.279 (P < 0.001), 68.660 (P < 0.001), 160.453 (P < 0.001), and 142.393 (P < 0.001), respectively. The values of the linear-by-linear association test were 68.737 (P < 0.001), 61.076 (P < 0.001), 128.738 (P < 0.001), and 141.591 (P < 0.001), respectively;

²If the expression of any one of the three biomarkers was positive, the combined expression was counted as positive; if there was an overlap in expression, the score of the strongest expression was taken as the score of the combination. ESCC: Esophageal squamous cell cancer; HGD: High-grade dysplasia; LGD: Low-grade dysplasia; BCH: Basal cell hyperplasia.