Construction of molecular targets based on gene expression profiling and clinical validation results: CEBPB enables accurate diagnosis of early esophageal carcinoma

The prevalence of esophageal squamous cell carcinoma (ESCC) among all cases of esophageal carcinoma in Asia exceeds 90%. The absence of reliable biomarkers and noticeable symptoms in the early stages often leads to delayed diagnosis and unfavorable prognosis for patients. The present study employed weighted gene coexpression network analysis (WGCNA) to identify a set of 1204 genes exhibiting strong correlations with stage T1 tumors. Differential analysis revealed 448 upregulated differentially expressed genes (DEGs) that were enriched primarily in immune- and tumor-related pathways. Through cross-analysis, we established a protein–protein interaction (PPI) network and identified seven key genes. Two key genes (CEBPB and CXCL8) were validated in external datasets and demonstrated good diagnostic efficiency according to receiver operating characteristic (ROC) curve analysis (area under the curve [AUC] > 0.8). Immune cell infiltration analysis revealed notable alterations in macrophage populations within ESCC tissues. Verification through Western blotting, immunohistochemistry, and immunofluorescence confirmed that CEBPB has superior identification efficiency. Five distinct cell types were identified in ESCC, and CEBPB expression was observed in all cellular categories. Tissue stem cells and epithelial cells exhibited strong intercellular communication with other cells, whereas TGFB1-(TGFBR1+TGFBR2) was widely expressed throughout all cell types. This study highlights the potential of CEBPB as a valuable biomarker for identifying ESCC, revealing its role in tumor progression and metastasis through immune microenvironment modulation. These results provide valuable insight into the timely identification and precise management of ESCC, with a specific focus on circumstances related to tumor progression.