Lymphatic invasion according to D2-40 immunostaining is a strong predictor of nodal metastasis in superficial squamous cell carcinoma of the esophagus: Algorithm for risk of nodal metastasis based on lymphatic invasion
Lymphatic invasion according to D2-40 immunostaining is a strong predictor of nodal metastasis in superficial squamous cell carcinoma of the esophagus: Algorithm for risk of nodal metastasis based on lymphatic invasion
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DOI：
10.1111/j.1440-1827.2008.02224.x
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发表时间：
2008-05-01
影响因子：
2.2
通讯作者：
Tsurumaru, Masahiko
中科院分区：
文献类型：
--
作者：
Tomita, Natsumi;Matsumoto, Toshiharu;Tsurumaru, Masahiko
在食管鳞状细胞癌（SCC）中，D2-40免疫染色最近被用于检测淋巴浸润，但使用D2-40免疫染色检测浸润是否预示淋巴结转移存在争议。因此，在食管浅表（粘膜和粘膜下）鳞状细胞癌中，研究了D2-40免疫染色检测淋巴浸润作为淋巴结转移预测因子的有效性。采用D2-40免疫组化检查食管浅表鳞状细胞癌115例。D2-40免疫染色显示的淋巴浸润主要见于固有层粘膜。37例发现淋巴浸润，整个肿瘤组织浸润与淋巴结转移有统计学相关性。根据D2-40免疫染色的淋巴浸润情况，设计了食管浅表鳞状细胞癌淋巴结转移风险（低、中、高）评估算法。总之，肿瘤组织中D2-40免疫染色检测淋巴浸润是食管浅表鳞状细胞癌淋巴结转移的有力预测指标。淋巴管侵袭主要发生在固有层粘膜，因此所设计的算法可用于确定食管鳞状细胞癌内镜黏膜切除术后的最佳治疗策略。
In squamous cell carcinoma (SCC) of the esophagus, D2-40 immunostaining has recently been used to detect lymphatic invasion, but invasion detected using D2-40 immunostaining for a predictor of nodal metastasis was controversial. Therefore, the usefulness of detecting lymphatic invasion by D2-40 immunostaining as a predictor of nodal metastasis was examined in superficial (mucosal and submucosal) SCC of the esophagus. A total of 115 superficial SCC of the esophagus were examined on immunohistochemistry using D2-40. It was found that lymphatic invasion demonstrated on D2-40 immunostaining was mainly detected in the lamina propria mucosa. Lymphatic invasion was found in 37 cases and the invasion detected in the entire tumor tissue was statistically correlated with nodal metastasis. Based on the lymphatic invasion according to D2-40 immunostaining, an algorithm was devised for the risk (low, intermediate and high) of nodal metastases in superficial SCC in the esophagus. In conclusion, the detection of lymphatic invasion on D2-40 immunostaining in tumor tissue is a strong predictor for nodal metastasis in superficial SCC of the esophagus. Lymphatic invasion was found mainly in the lamia propria mucosa, thus the devised algorithm is useful for determining the optimal treatment strategy after endoscopic mucosal resection for esophageal SCC.