Tumor cell dissociation score highly correlates with lymph node metastasis in superficial esophageal carcinoma
Tumor cell dissociation score highly correlates with lymph node metastasis in superficial esophageal carcinoma
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DOI：
10.1111/j.1440-1746.2005.03858.x
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发表时间：
2005-09-01
影响因子：
4.1
通讯作者：
Fujimori, T
中科院分区：
文献类型：
--
作者：
Chibana, Y;Fujii, S;Fujimori, T
背景：目前尚不清楚哪些参数对于预测浅表食管鳞状细胞癌（SESCC）的转移潜力很重要。因此，本文的目的是研究SESCC中的肿瘤细胞解离（TCD）作为淋巴结转移的预测因素。方法：根据肿瘤浸润深度将33例SESCC分为四组。未侵犯粘膜肌层的癌被分类为A组；癌侵犯粘膜肌层或上粘膜下层三分之一以下者为B组；侵犯粘膜下层中层者为C组；将TCD区域的长度除以侵入固有层或超出固有层的区域的最大纵向长度，乘以100计算TCD评分。TCD区域和粘膜浸润性癌（SAM）的连续区域检测癌E-cadherin的表达。结果：A组淋巴结转移发生率为0%， B组为10%，C组为36.4%，D组为57.1%。有淋巴结转移的SESCC平均TCD评分（+/-SEM）高于无淋巴结转移的SESCC（分别为85.3+/-5.7、16.3+/-3.9；P<0.001）。 C组有淋巴结转移病例TCD评分高于无淋巴结转移病例（P < 0.001）。与位于TCD区域的SAM相比，TCD区域E-cadherin表达显着降低（P < 0.001）。结论：TCD评分是SECC淋巴结转移的重要预测指标。内镜粘膜切除（EMR）标本中 TCD 评分的临床评估将能够准确预测淋巴结转移，并扩大 EMR 治疗 SECC 的适应症。 (C) 2005 年布莱克威尔出版亚洲有限公司。
Background: It is still not clear which parameters are important for predicting the metastatic potential of superficial esophageal squamous cell carcinoma (SESCC). The purpose of the present paper was thus to investigate tumor cell dissociation (TCD) in SESCC as a predictive factor of lymph node metastasis.Methods: Thirty-three SESCC were classified into four groups based on the depth of tumor invasion. Carcinomas not invading as far as the muscularis mucosa were classified as group A; carcinomas invading to the muscularis mucosa or less than one-third of the upper submucosa were classified as group B; those invading to the middle layer of the submucosa were classified as group C; and those invading one-third of the lower submucosa were classified as group D. The TCD score was calculated by dividing the length of the TCD region by the maximal longitudinal length of the area of invasion into or beyond the lamina propria, and multiplying by 100. E-cadherin expression of the carcinomas was investigated in the TCD area and the successive area of mucosal invasive carcinoma (SAM).Results: The incidence of lymph node metastasis was 0% in group A, 10% in group B, 36.4% in group C and 57.1% in group D. The mean TCD scores (+/- SEM) of SESCC with lymph node metastasis were higher than that without (85.3 +/- 5.7, 16.3 +/- 3.9, respectively; P < 0.001). In group C, the TCD score of cases with lymph node metastases was higher than in those without lymph node metastasis (P < 0.001). E-cadherin expression was significantly reduced in the area of TCD compared with the SAM located over the TCD area (P < 0.001).Conclusions: The TCD score is an important predictive marker for lymph node metastasis in SESCC. Clinical evaluation of TCD scores in endoscopic mucosal resection (EMR) specimens would enable accurate prediction of lymph node metastasis and extend the indication of EMR treatment for SESCC. (C) 2005 Blackwell Publishing Asia Pty Ltd.