Carcinosarcoma of the esophagus: A report of 6 cases associated with zinc finger E-box-binding homeobox 1 expression
Carcinosarcoma of the esophagus: A report of 6 cases associated with zinc finger E-box-binding homeobox 1 expression
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DOI：
10.3892/ol.2018.9585
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发表时间：
2019-01-01
期刊：
影响因子：
2.9
通讯作者：
Yamashita, Keishi
中科院分区：
文献类型：
--
作者：
Harada, Hiroki;Hosoda, Kei;Yamashita, Keishi
食管癌肉瘤（ECS）被认为是由上皮间质转化（EMT）现象引起的。然而，对其潜在分子特征的了解是有限的。ECS的临床病理特点及预后有待进一步研究。本研究于2004年1月至2014年12月共观察了325例食管肿瘤患者，其中6例患者病理诊断为ECS。将其临床病理特征与病理T期相同的食管鳞癌（ESCC）相应病例进行比较。在临床T分期（cT）方面，6例患者分别由cT1、cT2、cT3、cT4组成1例、1例、3例、1例。然而，所有病例的pT最终都被诊断为pT1。术前临床诊断的肿瘤浸润深度与术后诊断的肿瘤浸润深度存在较大差异。锌指E-box-binding homeobox 1 （ZEB1）是一种emt相关的转录因子，在所有6例ECS中仅在肉瘤成分中表达。与115例pT1 ESCC病例相比，ECS病例的预后明显较差。本研究提示ECS病变的浸润深度与其各自的大小并不对应，癌成分的EMT可能通过ZEB1基因的过表达影响预后。
Esophageal carcinosarcoma (ECS) has been suggested to result from an epithelial mesenchymal transition (EMT) phenomenon. However, knowledge on its underlying molecular features is limited. The clinical and pathological features, and the prognosis of ECS require further investigation. In the present study, a total of 325 patients with esophageal tumors were observed between January 2004 and December 2014, of which 6 patients were diagnosed pathologically with ECS. The clinicopathological features were compared with those of corresponding cases with the identical pathological T stage (pT) of esophageal squamous cell carcinoma (ESCC). In terms of the clinical T stage (cT), the 6 cases were composed of cT1, cT2, cT3 and cT4 in 1, 1, 3 and 1 case, respectively. Nevertheless, pT was eventually diagnosed as pT1 in all cases. There was a large discrepancy between clinically diagnosed depth of tumor invasion prior to surgery and depth of tumor invasion following surgery. Zinc finger E-box-binding homeobox 1 (ZEB1), an EMT-associated transcription factor, was expressed only in the sarcoma component in all 6 cases of ECS. The ECS cases had a significantly poorer prognosis compared with the 115 pT1 ESCC cases. The present study suggests that the depth of invasion of ECS lesions does not correspond with their respective size, and the EMT of the carcinoma component may affect the prognosis by overexpression of the ZEB1 gene.