Sakai Akihiro, Nakashima Yuichiro, Miyashita Yu, Ao Tadakazu, Kimura Yasue, Shinto Eiji, Oki Eiji, Shimokawa Mototsugu, Ueno Hideki, Oda Yoshinao, Mori Masaki
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Anatomic Pathology, Pathological Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Histopathology. 2021 Aug;79(2):219-226. doi: 10.1111/his.14357. Epub 2021 May 28.
Histological categorisation of the desmoplastic reaction (DR) is an independent prognostic factor in colorectal cancer. However, it is unknown whether DR categorisation is predictive of oesophageal squamous cell carcinoma (OSCC) outcomes. This study aimed to evaluate the prognostic value of DR categorisation in OSCC patients.
Data were collected from 118 patients with OSCC who underwent a curative oesophagectomy with T2 or deeper wall invasion. The DR in each tumour was classified as mature, intermediate or immature based on the presence or absence of keloid-like collagen and myxoid stroma. We identified 49 mature DR tumours, 41 intermediate DR tumours and 28 immature DR tumours. The 5-year overall survival (OS) rate was highest in the mature DR group (42.8%), followed by the intermediate DR group (25.0%) and the immature DR group (19.9%) (P = 0.022, log-rank test; P = 0.006, log-rank trend test). The 5-year disease-specific survival (DSS) rate was also highest in the mature DR group (48.5%), followed by the intermediate DR group (30.8%) and the immature DR group (26.8%) (P = 0.031, log-rank test; P = 0.010, log-rank trend test, respectively). Multivariate analysis revealed that an immature DR was an independent poor prognostic factor of OS and DSS (P = 0.002 and P = 0.004).
DR categorisation of OSCC stroma following oesophagectomy is a useful diagnostic tool and an independent prognostic marker.
促纤维组织增生性反应（DR）的组织学分类是结直肠癌的一个独立预后因素。然而，DR分类是否能预测食管鳞状细胞癌（OSCC）的预后尚不清楚。本研究旨在评估DR分类对OSCC患者的预后价值。
收集了118例行根治性食管切除术且肿瘤侵犯食管壁达T2或更深的OSCC患者的数据。根据是否存在瘢痕疙瘩样胶原和黏液样基质，将每个肿瘤的DR分为成熟型、中间型或未成熟型。我们鉴定出49个成熟DR肿瘤、41个中间DR肿瘤和28个未成熟DR肿瘤。成熟DR组的5年总生存率（OS）最高（42.8%），其次是中间DR组（25.0%）和未成熟DR组（19.9%）（P = 0.022，对数秩检验；P = 0.006，对数秩趋势检验）。成熟DR组的5年疾病特异性生存率（DSS）也最高（48.5%），其次是中间DR组（30.8%）和未成熟DR组（26.8%）（分别为P = 0.031，对数秩检验；P = 0.010，对数秩趋势检验）。多因素分析显示，未成熟DR是OS和DSS的独立不良预后因素（P = 0.002和P = 0.004）。
食管切除术后OSCC基质的DR分类是一种有用的诊断工具和独立的预后标志物。
