FSTL1 promotes metastasis and chemoresistance in esophageal squamous cell carcinoma through NFκB-BMP signaling cross-talk

Marco Chi-Chung Lau, Kai Yu Ng, Tin Lok Wong, Man Tong, Kin Wah Lee, Xiao Yan Ming, Simon Law, Nikki P. Lee, Annie L. Cheung, Yan Ru Qin, Kwok Wah Chan, Wen Ning, Xin Yuan Guan, Stephanie Ma

Research output: Journal article publicationJournal articleAcademic researchpeer-review

46 Citations (Scopus)


Esophageal squamous cell carcinoma (ESCC) has a generally poor prognosis, and molecular markers to improve early detection and predict outcomes are greatly needed. Here, we report that the BMP-binding follistatin-like protein FSTL1 is overexpressed in ESCCs, where it correlates with poor overall survival. Genetic amplification of FSTL1 or chromosome 3q, where it is located, occurred frequently in ESCC, where FSTL1 copy number correlated positively with higher FSTL1 protein expression. Elevating FSTL1 levels by various means was sufficient to drive ESCC cell proliferation, clonogenicity, migration, invasion, self-renewal, and cisplatin resistance in vitro and tumorigenicity and distant metastasis in vivo. Conversely, FSTL1 attenuation by shRNA or neutralizing antibody elicited the opposite effects in ESCC cells. mRNA profiling analyses suggested that FSTL1 drives ESCC oncogenesis and metastasis through various pathways, with deregulation of NFκB and BMP signaling figuring prominently. Cross-talk between the NFκB and BMP pathways was evidenced by functional rescue experiments using inhibitors of NFκB and TLR4. Our results establish the significance of FSTL1 in driving oncogenesis and metastasis in ESCC by coordinating NFκB and BMP pathway control, with implications for its potential use as a diagnostic or prognostic biomarker and as a candidate therapeutic target in this disease setting.
Original languageEnglish
Pages (from-to)5886-5899
Number of pages14
JournalCancer Research
Issue number21
Publication statusPublished - 1 Nov 2017

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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