Endhardt Katharina, Märkl Bruno, Probst Andreas, Schaller Tina, Aust Daniela
Institute of Pathology, Klinikum Augsburg, Augsburg 86156, Germany.
Department of Gastroenterology, Klinikum Augsburg, Augsburg 86156, Germany.
World J Gastrointest Oncol. 2017 Nov 15;9(11):444-451. doi: 10.4251/wjgo.v9.i11.444.
To test the validity of tumour thickness measurement in distinguishing between the different infiltration depths, especially when the duplication of muscularis mucosae cannot be demarcated clearly.
We re-evaluated 100 completely embedded Barrett's adenocarcinomas regarding m-classification, maximum tumour thickness, and muscularis mucosae duplication. For validation, smoothelin staining was performed on a subset of cases.
The m1-, m2- and m3-classified adenocarcinomas showed a significant lower tumour thickness compared to the m4- and sm1-classified lesions ( < 0.001). Smoothelin staining determined a clear muscularis mucosae duplication in 64% of the tested samples and enabled the differentiation of the two layers in diffuse and merged splits.
Tumour thickness in early oesophageal adenocarcinoma significantly correlates with the depth of infiltration and demonstrates its worth as an accurate pT classification in non-polypoid lesions. We created a new algorithm, which combines histomorphology with morphometric analyses. It is noteworthy that it facilitates the assessment of mucosal submucosal infiltration depth. The smoothelin staining strengthened our results of the tumour thickness evaluation and can be used in cases of doubt.
检验肿瘤厚度测量在区分不同浸润深度方面的有效性，尤其是在黏膜肌层复制无法清晰界定的情况下。
我们对100例完全包埋的巴雷特腺癌重新评估了m分类、最大肿瘤厚度和黏膜肌层复制情况。为进行验证，对部分病例进行了平滑肌肌动蛋白染色。
与m4和sm1分类的病变相比，m1、m2和m3分类的腺癌肿瘤厚度显著更低（<0.001）。平滑肌肌动蛋白染色在64%的测试样本中确定了清晰的黏膜肌层复制，并能够在弥漫性和融合性分裂中区分这两层。
早期食管腺癌的肿瘤厚度与浸润深度显著相关，并证明其作为非息肉样病变准确pT分类的价值。我们创建了一种新算法，将组织形态学与形态计量分析相结合。值得注意的是，它有助于评估黏膜下层浸润深度。平滑肌肌动蛋白染色强化了我们肿瘤厚度评估的结果，可用于存在疑问的病例。
