Degree of histological differentiation is an important characteristic of
cancers and may be associated with malignant potential. However, in
squamous cell carcinomas, a key transcriptional factor regulating
tumor differentiation is largely unknown.
Chemoradiotherapy (CRT) is a standard treatment for locally advanced
esophageal squamous cell carcinoma; however, the survival rate is still below 40%. From microarray data, single-minded 2 (SIM2) was overexpressed in the epithelial subtype. Here, we investigated the correlation between SIM2 expression and its clinical implication, and in vitro and in vivo functions of SIM2 in
tumor differentiation and in CRT sensitivity. Although SIM2 was suppressed in cancerous tissues, SIM2-high ESCC showed a favorable prognosis in CRT. Transient SIM2 expression followed by 3D culture induced expression of
differentiation markers and suppressed epithelial-mesenchymal transition- and basal-cell markers. Levels of PDPN-high
tumor basal cells and of expression of genes for DNA repair and
antioxidant enzymes were reduced in stable transfectants, and they showed high CDDP and H2 O2 sensitivities, and their xenografts showed a well-differentiated histology. Reduction of
tumor basal cells was restored by knockdown of
aryl hydrocarbon receptor nuclear translocator (ARNT) that interacted with SIM2. Together, SIM2 increases CRT sensitivity through
tumor differentiation by cooperation with ARNT.