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World J Gastroenterol. Dec 14, 2025; 31(46): 112664
Published online Dec 14, 2025. doi: 10.3748/wjg.v31.i46.112664
Ethnic genomic differences in esophageal squamous cell carcinoma: Whole-exome sequencing of Han and Kazakh populations in China
Meng-Xia Wei, Ling-Ling Lei, Rui-Hua Xu, Yong-Xuan Liu, Ran Wang, Wen-Li Han, Zong-Min Fan, Fan-Kai Xiao, Ilyar Sheyhidin, Lei Ma, Jian-Wei Ku, Ming-Zhu Yin, Ai-Fang Ji, Qi-De Bao, She-Gan Gao, Xue-Na Han, Xin-Min Li, Pei-Nan Chen, Xue-Ke Zhao, Xin Song, Li-Dong Wang
Meng-Xia Wei, Ling-Ling Lei, Rui-Hua Xu, Yong-Xuan Liu, Ran Wang, Wen-Li Han, Zong-Min Fan, Fan-Kai Xiao, Xue-Na Han, Xue-Ke Zhao, Xin Song, Li-Dong Wang, Henan Key Laboratory for Esophageal Cancer Research and National Key Laboratory of Metabolic Dysregulation and Esophageal Cancer Prevention and Treatment, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
Yong-Xuan Liu, Henan Key Laboratory of Cancer Epigenetic, Henan Key Laboratory of Microbiome and Esophageal Cancer Prevention and Treatment, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang 471003, Henan Province, China
Ilyar Sheyhidin, Department of Thoracic Surgery and Medical Research Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
Lei Ma, Tumor Laboratory, The First People’s Hospital of Nanyang, Nanyang 473000, Henan Province, China
Jian-Wei Ku, Department of Gastroenterology, The Second Affiliated Hospital of Nanyang Medical College, Nanyang 473000, Henan Province, China
Ming-Zhu Yin, Clinical Research Center, Clinical Pathology Center, Cancer Early Detection and Treatment Center and Translational Medicine Research Center, Chongqing University Three Gorges Hospital, Chongqing University, Chongqing 400030, China
Ai-Fang Ji, Department of Clinical Laboratory, Heping Hospital Affiliated to Changzhi Medical College, Changzhi 046000, Shanxi Province, China
Qi-De Bao, Department of Oncology, Anyan District Hospital, Anyang 455000, Henan Province, China
She-Gan Gao, Department of Oncology, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang 471003, Henan Province, China
Xin-Min Li, Department of Pathology, The Maternal and Child Health Care Hospital of Zhengzhou, Zhengzhou 450052, Henan Province, China
Pei-Nan Chen, Department of Thoracic Surgery, The Affiliated Cancer Hospital, Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, Henan Province, China
Author contributions: Wang LD conceptualized the work; Lei LL, Xu RH, Liu YX, Wang R, Han WL, Fan ZM, Xiao FK, Chen PN, Zhao XK, Song X and Han XN reviewed and edited the work; Wei MX wrote the original draft, completed the final draft before all authors read and approved the final version of the manuscript; Sheyhidin I, Ma L, Ku JW, Yin MZ, Ji AF, Bao QD, Gao SG, Han XN, and Li XM collected samples and performed the research.
Supported by the National Natural Science Foundation of China, No. U1301227; National Major Science and Technology Projects, No. 2024ZD05209060; and Henan Province Jointly Built Science and Technology Key Projects, No. LHGJ20210337.
Institutional review board statement: This study was approved by the Ethical Committee of Faculty of the First Affiliated Hospital of Zhengzhou University (Ethics approval number: No. 2024-KY-2336-002).
Institutional animal care and use committee statement: This study didn’t contain any animal research.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: The datasets generated during this study are fully available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li-Dong Wang, MD, Professor, Henan Key Laboratory for Esophageal Cancer Research and National Key Laboratory of Metabolic Dysregulation and Esophageal Cancer Prevention and Treatment, The First Affiliated Hospital of Zhengzhou University, No. 40 Daxue Road, Zhengzhou 450052, Henan Province, China. ldwang2007@126.com
Received: August 4, 2025
Revised: September 17, 2025
Accepted: November 3, 2025
Published online: December 14, 2025
Processing time: 130 Days and 2 Hours
Abstract
BACKGROUND

Esophageal squamous cell carcinoma (ESCC) is a cancer with a poor prognosis, characterized by distinct geographical distribution and family clustering.

AIM

To investigate if ethnic differences (Han vs Kazakh) cause molecular variations in ESCC patients via genomic sequencing 299 samples.

METHODS

Here, we sequenced samples from 299 ESCC patients collected from Henan Key Laboratory for Esophageal Cancer Research and National Key Laboratory of Metabolic Dysregulation and Esophageal Cancer Prevention and Treatment, The First Affiliated Hospital of Zhengzhou University, including Han and Kazakh ethnic groups, and performed a genomic comparative analysis of these two ethnic cohorts.

RESULTS

ESCC patients of Kazakh ethnicity present with a later age of onset compared to Han. Kazakh patients exhibit a slightly higher tumor mutation burden compared to their Han counterparts. Three genes GIGYF1, CACNA1D, and ACOT11 exhibited mutation frequencies threefold higher in Kazakh patients than in Han. This enrichment may be associated with Kazakhs’ adaptation to cold climates and consumption of high-calorie diets. Among Han patients, the apolipoprotein B messenger RNA-editing enzyme catalytic polypeptide (APOBEC)-associated single base substitutions (SBS) 13 mutational signature is more prevalent, whereas SBS6, indicative of DNA mismatch repair deficiency, is more common in Kazakh patients. Additionally, Han Chinese patients with APOBEC-enriched tumors exhibit a significantly higher mutation load than those without. Moreover, patients lacking the APOBEC signature demonstrate superior survival probability compared to the APOBEC-enriched group.

CONCLUSION

Living environment and diet are major factors in the development of ESCC. Genomic difference may provide guidance for the formulation of clinical treatment plans for ESCC from different ethnics regions.

Keywords: Esophageal squamous cell carcinoma; Han; Kazakh; Ethnic difference; Whole-exome sequencing; Diet; Apolipoprotein B messenger RNA-editing enzyme catalytic polypeptide; Single base substitutions 6

Core Tip: This study aimed to explore if ethnic differences (Han vs Kazakh) cause molecular variations in Chinese esophageal squamous cell carcinoma (ESCC) patients, affecting treatment response. It sequenced 299 ESCC samples, found ethnic differences in difference genes (e.g., GIGYF1), tumor mutation burden, mutational signatures (apolipoprotein B messenger RNA-editing enzyme catalytic polypeptide/single base substitutions 6), linked to environment/diet. Results may guide ethnic-specific ESCC treatment.