Objective Studying the effect of PRDX4 on esophageal squamous cell carcinoma cells (esophageal carcinoma, ESCC) proliferation and apoptosis as well as its potential mechanism.

Methods The University of Alabama at Birmingham cancer data analysis portal (UALCAN), gene expression profiling interactive analysis (GEPIA) and the Cancer Genome Atlas (TCGA) databases were used to predict PRDX4 expression in ESCC and its relationship with pathological features and prognosis. The cancer and adjacent tissues of 60 patients with ESCC who underwent radical resection in the Affiliated Hospital of Weifang Medical College from August 2010 to August 2023 were selected as research samples. The expression level of PRDX4 in the patients was detected by immunohistochemistry (IHC). The extracted cancer and adjacent tissues were homogenized to analyze its mRNA expression. The expression levels of PRDX4 mRNA and related signaling proteins in ESCC cells were analyzed by real-time quantitative PCR and Western blot. Cell Counting Kit-8 (CCK-8) assay and flow cytometry were used to analyze the effect of PRDX4 on cell proliferation and apoptosis. Finally, a subcutaneous tumor model in nude mice was constructed to validate the in vitro experimental results.

Results The data from the GEPIA and UALCAN showed that PRDX4 expression was abnormally increased and related to the pathology stage, grade, and survival rate of patients. After knockdown and overexpression of PRDX4 in an ESCC cell line, the expression of PRDX4, phos-phosphatidylinositol 3-kinase (p-PI3K), phos-protein kinase B (p-AKT), cyclinD1, and survivin protein decreased and increased, respectively; cell proliferation and apoptosis were positively regulated. Compared with the sh-NC group, tumor volume and weight in the sh-PRDX4 group were decreased.

Conclusions PRDX4 regulates the proliferation and apoptosis of ESCC cells by activating the PI3K/AKT signaling pathway.