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Esophagus

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01.04.2015 | Original Article

Histopathological and immunohistochemical characteristics of superficial squamous cell carcinoma forming droplet infiltration: indicator of lymph node metastasis of the esophagus

verfasst von: Ryuta Nakao, Yasuko Fujita, Nobuaki Yagi, Eiichi Konishi, Akio Yanagisawa

Erschienen in: Esophagus | Ausgabe 2/2015

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Abstract

Background

Droplet infiltration (DI) is a tumor infiltration pattern observed in superficial squamous cell carcinoma (SSCC) of the esophagus. Lymph node metastasis (LNM) is related to three reported features of DI (DILFs): longitudinal diameter ≤20 μm (DIsLF); number of constituent cells ≤4 (DInLF); distance from the primary focus ≥200 μm (DIdLF). The aim of this study was to clarify the characteristics of SSCC with high risk of LNM, by analyzing DILF-forming SSCC histopathologically and immunohistochemically.

Methods

Forty-five SSCC invading the muscularis mucosa or submucosa were divided into two groups with and without above-mentioned three DILFs. The Ki-67 labeling index (LI) and the expression of cytokeratin (CK) 13, 14, 17, and 19 were compared in the paired.

Results

The Ki-67 LI was elevated in SSCC with DIsLF and with DInLF (P < 0.001, each), but no significant difference was observed between SSCC with and without DIdLF. The expression of CK13 was decreased in SSCC with DIsLF (P < 0.01) and with DInLF (P < 0.001), but no significant difference was observed between SSCC with and without DIdLF. For CK14, CK17, and CK19, no significant difference was observed between SSCC with and without any DILF.

Conclusions

The results indicated that DIsLF and DInLF are not only LNM predictors, but useful morphological markers reflecting excessive cell proliferation, and that the reduced expression of CK13 is closely associated with DIsLF and DInLF formation at the invasive front. Therefore, the elevation of Ki-67 LI and reduced expression of CK13 suggest higher risk of LNM in esophageal SSCC.

Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2010;127:2893–917.CrossRefPubMed

Center for Cancer Control and Information Services. Cancer statistics in Japan-2012. Tokyo: National Cancer Center; 2012. p. 12–3.

Ozawa S, Tachimori Y, Baba H, Fujishiro M, Matsubara H, Numasaki H, et al. Comprehensive Registry of Esophageal Cancer in Japan, 2004. Esophagus. 2012;9:75–98.CrossRef

Japan Esophageal Society. Japanese classification of esophageal cancer, tenth edition: part I. Esophagus. 2009;6:1–25.CrossRef

Takahashi H, Arimura Y, Masao H, Okahara S, Tanuma T, Kodaira J, et al. Endoscopic submucosal dissection is superior to conventional endoscopic resection as a curative treatment for early squamous cell carcinoma of the esophagus (with video). Gastrointest Endosc. 2010;72:255–64.CrossRefPubMed

Urabe Y, Hiyama T, Tanaka S, Yoshihara M, Arihiro K, Chayama K. Advantages of endoscopic submucosal dissection versus endoscopic oblique aspiration mucosectomy for superficial esophageal tumors. J Gastroenterol Hepatol. 2011;26:275–80.CrossRefPubMed

Kodama M, Kakegawa T. Treatment of superficial cancer of the esophagus: a summary of responses to a questionnaire on superficial cancer of the esophagus in Japan. Surgery. 1998;123:432–9.CrossRefPubMed

Eguchi T, Nakanishi Y, Shimoda T, Iwasaki M, Igaki H, Tachimori Y, et al. Histopathological criteria for additional treatment after endoscopic mucosal resection for esophageal cancer: analysis of 464 surgically resected cases. Mod Pathol. 2006;19:475–80.CrossRefPubMed

Motoyama S, Jin M, Matsuhashi T, Nanjo H, Ishiyama K, Sato Y, et al. Outcomes of patients receiving additional esophagectomy after endoscopic resection for clinically mucosal, but pathologically submucosal, squamous cell carcinoma of the esophagus. Surg Today. 2013;43:638–42.CrossRefPubMed

10.

Makuuchi H, Shimada H, Chino O, Tanaka Y, Nishi T, Oshiba G, et al. Possibility of endoscopic mucosal resection in patients with m3 and sm1 esophageal cancer (in Japanese with English abstract). Stomach Intest. 1998;33:993–1002.

11.

Oyama T, Miyata Y, Simatani S, Tomori A, Hotta K, Yoshida M. Lymph nodal metastasis of m3, sm1 esophageal cancer (in Japanese with English abstract). Stomach Intest. 2002;37:71–4.

12.

Yamashina T, Ishihara R, Nagai K, Matsuura N, Matsui F, Ito T, et al. Long-term outcome and metastatic risk after endoscopic resection of superficial esophageal squamous cell carcinoma. Am J Gastroenterol. 2013;108:544–51.CrossRefPubMed

13.

Egashira H, Yanagisawa A, Kato Y. Predictive factors for lymph node metastasis in esophageal squamous cell carcinomas contacting or penetrating the muscularis mucosae: the utility of droplet infiltration. Esophagus. 2006;3:47–52.CrossRef

14.

Youssef EM, Matsuda T, Takada N, Osugi H, Higashino M, Kinoshita H, et al. Prognostic significance of the MIB-1 proliferation index for patients with squamous cell carcinoma of the esophagus. Cancer. 1995;76:358–66.CrossRefPubMed

15.

Ikeda G, Isaji S, Chandra B, Watanabe M, Kawarada Y. Prognostic significance of biologic factors in squamous cell carcinoma of the esophagus. Cancer. 1999;86:1396–405.CrossRefPubMed

16.

Sasagawa H, Shiozaki A, Iitaka D, Ichikawa D, Komatsu S, Fujiwara H, et al. Ki-67 labeling index as an independent prognostic factor in human esophageal squamous cell carcinoma. Esophagus. 2012;9:195–202.CrossRef

17.

Ohashi K, Nemoto T, Eishi Y, Matsuno A, Nakamura K, Hirokawa K. Proliferative activity and p53 protein accumulation correlate with early invasive trend, and apoptosis correlates with differentiation grade in oesophageal squamous cell carcinomas. Virchows Arch. 1997;430:107–15.CrossRefPubMed

18.

Kawamura T, Goseki N, Koike M, Takizawa T, Endo M. Acceleration of proliferative activity of esophageal squamous cell carcinoma with invasion beyond the mucosa: immunohistochemical analysis of Ki-67 and p53 antigen in relation to histopathologic findings. Cancer. 1996;77:843–9.CrossRefPubMed

19.

Chino O, Makuuchi H, Shimada H, Machimura T, Mitomi T, Osamura RY. Assessment of the proliferative activity of superficial esophageal carcinoma using MIB-1 immunostaining for the Ki-67 antigen. J Surg Oncol. 1998;67:18–24.CrossRefPubMed

20.

Takahashi H, Shikata N, Senzaki H, Shintaku M, Tsubura A. Immunohistochemical staining patterns of keratins in normal oesophageal epithelium and carcinoma of the oesophagus. Histopathology. 1995;26:45–50.CrossRefPubMed

21.

Lam KY, Loke SL, Shen XC, Ma LT. Cytokeratin expression in non-neoplastic oesophageal epithelium and squamous cell carcinoma of the oesophagus. Virchows Arch. 1995;426:345–9.CrossRefPubMed

22.

Yamada A, Sasaki H, Aoyagi K, Sano M, Fujii S, Daiko H, et al. Expression of cytokeratin 7 predicts survival in stage I/IIA/IIB squamous cell carcinoma of the esophagus. Oncol Rep. 2008;20:1021–7.PubMed

23.

Makino T, Yamasaki M, Takeno A, Shirakawa M, Miyata H, Takiguchi S, et al. Cytokeratins 18 and 8 are poor prognostic markers in patients with squamous cell carcinoma of the oesophagus. Br J Cancer. 2009;101:1298–306.CrossRefPubMedCentralPubMed

24.

Ida-Yonemochi H, Maruyama S, Kobayashi T, Yamazaki M, Cheng J, Saku T. Loss of keratin 13 in oral carcinoma in situ: a comparative study of protein and gene expression levels using paraffin sections. Mod Pathol. 2012;25:784–94.CrossRefPubMed

25.

Mikami T, Cheng J, Maruyama S, Kobayashi T, Funayama A, Yamazaki M, et al. Emergence of keratin 17 vs. loss of keratin 13: their reciprocal immunohistochemical profiles in oral carcinoma in situ. Oral Oncol. 2011;47:497–503.CrossRefPubMed

26.

Safadi RA, Musleh AS, Al-Khateeb TH, Hamasha AA. Analysis of immunohistochemical expression of k19 in oral epithelial dysplasia and oral squamous cell carcinoma using color deconvolution-image analysis method. Head Neck Pathol. 2010;4:282–9.CrossRefPubMedCentralPubMed

27.

Takashima M, Kawachi H, Yamaguchi T, Nakajima Y, Kitagaki K, Sekine M, et al. Reduced expression of cytokeratin 4 and 13 is a valuable marker for histologic grading of esophageal squamous intraepithelial neoplasia. J Med Dent Sci. 2012;59:17–28.PubMed

28.

Nakayama H, Mitomi H, Imamhasan A, Uchida S, Tomita N, Kajiyama Y, et al. Stepwise overexpression of p63, p53, and cytokeratin 14 during progression of esophageal squamous intraepithelial neoplasia: useful immunohistochemical markers for differential diagnosis. Esophagus. 2011;9:1–8.CrossRef

29.

Malecha MJ, Miettinen M. Expression of keratin 13 in human epithelial neoplasms. Virchows Arch A Pathol Anat Histopathol. 1991;418:249–54.CrossRefPubMed

30.

Chu PG, Lyda MH, Weiss LM. Cytokeratin 14 expression in epithelial neoplasms: a survey of 435 cases with emphasis on its value in differentiating squamous cell carcinomas from other epithelial tumours. Histopathology. 2001;39:9–16.CrossRefPubMed

31.

Kwaspen FH, Smedts FM, Broos A, Bulten H, Debie WM, Ramaekers FC. Reproducible and highly sensitive detection of the broad spectrum epithelial marker keratin 19 in routine cancer diagnosis. Histopathology. 1997;31:503–16.CrossRefPubMed

32.

Troyanovsky SM, Guelstein VI, Tchipysheva TA, Krutovskikh VA, Bannikov GA. Patterns of expression of keratin 17 in human epithelia: dependency on cell position. J Cell Sci. 1989;93(Pt 3):419–26.PubMed

33.

Roh MS, Lee JI, Choi PJ. Tumor budding as a useful prognostic marker in esophageal squamous cell carcinoma. Dis Esophagus. 2004;17:333–7.CrossRefPubMed

34.

Koike M, Kodera Y, Itoh Y, Nakayama G, Fujiwara M, Hamajima N, et al. Multivariate analysis of the pathologic features of esophageal squamous cell cancer: tumor budding is a significant independent prognostic factor. Ann Surg Oncol. 2008;15:1977–82.CrossRefPubMed

35.

Nakanishi Y, Ohara M, Doumen H, Kimura N, Ishidate T, Kondo S. Correlation between tumor budding and post-resection prognosis in patients with invasive squamous cell carcinoma of the thoracic esophagus. World J Surg. 2011;35:349–56.CrossRefPubMed

Titel: Histopathological and immunohistochemical characteristics of superficial squamous cell carcinoma forming droplet infiltration: indicator of lymph node metastasis of the esophagus
verfasst von: Ryuta Nakao
Yasuko Fujita
Nobuaki Yagi
Eiichi Konishi
Akio Yanagisawa
Publikationsdatum: 01.04.2015
Verlag: Springer Japan
Erschienen in: Esophagus / Ausgabe 2/2015
Print ISSN: 1612-9059
Elektronische ISSN: 1612-9067
DOI: https://doi.org/10.1007/s10388-014-0459-z

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Abstract

Background

Methods

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Conclusions

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