Objective To explore the protein expression of (zinc finger transcription factor 24) in esophageal squamous cell carcinoma (ESCC), and to investigate the correlations between ZNF24 protein expression with clinicopathological factors and its prognostic value.

Methods The protein expression of ZNF24 in tissue microarray (TMA) consisting of 513 patients with ESCC was detected by immunohistochemistry (IHC).Correlation between clinical features and survival time was evaluated by χ² test and Kaplan-Meier analysis.Univariate and multivariate Cox regression models were performed to identify associations with outcome variables.

Results A total of 513 patients with ESCC were included in the analysis, including 420 males and 93 females, with a mean age of 61.2 years old (34-83 years old), and were followed up until December 2018.The results showed that ZNF24 protein high expression occurred in 73.7% of ESCC patients, which was significantly correlated with tumor size (P < 0.001) and tumor location (P=0.038).Survival analysis indicated that disease free survival (DFS) and overall survival (OS) of patients with ZNF24 high expression had a trend of poorer survival (DFS, P=0.524;OS, P=0.527).In particular, when DFS was more than 28 months, the survival time of patients with high expression of ZNF24 was significantly shortened (P=0.035).Similarly, when OS was more than 35 months, patients with ZNF24 high expression had a significant worse prognosis (P=0.036).However, ZNF24 protein high expression was not an independent prognostic factor for ESCC.

Conclusions ZNF24 protein is overexpressed in ESCC, and patients with high expression have poor prognosis in DFS and OS, especially when DFS was more than 28 months and OS was more than 35 months.ZNF24 is an important reference index for poor prognosis.