Department of Pathology, University Hospital of Copenhagen, Rigshospitalet, Frederik V's Vej 11, 2100 Copenhagen, Denmark; Department of Pathology, University Hospital of Copenhagen, Hvidovre Hospital, Kettegård Alle 30, 2650 Hvidovre, Denmark.
Department of Pathology, University Hospital of Copenhagen, Rigshospitalet, Frederik V's Vej 11, 2100 Copenhagen, Denmark.
Ann Diagn Pathol. 2020 Apr;45:151478. doi: 10.1016/j.anndiagpath.2020.151478. Epub 2020 Feb 14.
The most common malignancy of the esophagus is squamous cell carcinoma (SCC) and regional lymph node metastases are an important prognostic factor. Isolated tumor cells (ITCs) are defined as single tumor cells or small clusters of tumor cells not exceeding 0.2 mm. The prognostic role of ITCs is not clear. This study aimed to determine the prevalence of ITCs in regional lymph nodes in patients with esophageal SCC and to investigate how frequently ITCs represent part of a true metastasis. Surgical specimens from 100 patients with SCC of the esophagus were included. All original H&E stained slides containing lymph nodes were reviewed by two gastrointestinal pathologists. In lymph nodes containing ITCs, additional levels were cut and stained with a H&E- and a cytokeratin stain. Areas of tumor cells that measured >0.2 mm on the deeper sections were classified as metastases. A total of 2460 lymph nodes were examined. ITCs were detected in 10 lymph nodes (0.4%) from nine patients (9%). Deeper sections revealed metastases in five out of the 10 lymph nodes (50%). ITCs in regional lymph nodes of patients with SCC of the esophagus is a rare finding compared with patients with adenocarcinoma of the esophagogastric junction. However, deeper sections often revealed metastases. Therefore, in patients with SCC of the esophagus, we recommend additional sectioning and immunohistochemical examination of lymph nodes when ITCs are detected on the first slide.
食管最常见的恶性肿瘤是鳞状细胞癌（SCC），区域淋巴结转移是一个重要的预后因素。孤立肿瘤细胞（ITCs）被定义为单个肿瘤细胞或不超过 0.2 毫米的小肿瘤细胞簇。ITCs 的预后作用尚不清楚。本研究旨在确定食管 SCC 患者区域淋巴结中 ITCs 的发生率，并探讨 ITCs 作为真正转移的一部分的频率。纳入了 100 例食管 SCC 患者的手术标本。由两位胃肠病理学家对所有包含淋巴结的原始 H&E 染色切片进行了回顾。在含有 ITCs 的淋巴结中，额外切取组织并用 H&E 和细胞角蛋白染色进行染色。在深层切片上测量>0.2 毫米的肿瘤细胞区域被归类为转移。共检查了 2460 个淋巴结。在 9 名患者的 10 个淋巴结（0.4%）中发现了 ITCs。在这 10 个淋巴结中，深层切片显示有 5 个（50%）有转移。与食管胃结合部腺癌患者相比，食管 SCC 患者的区域淋巴结中的 ITCs 发现较为罕见。然而，深层切片通常显示有转移。因此，对于食管 SCC 患者，当在第一张切片上发现 ITCs 时，我们建议对淋巴结进行额外的切片和免疫组织化学检查。
