Institute of Clinical Pathology, Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College.
Department of Pathology.
Am J Surg Pathol. 2023 Jul 1;47(7):766-773. doi: 10.1097/PAS.0000000000002048. Epub 2023 May 18.
The role of extramural venous invasion (EMVI) in esophageal cancer is still unclear. This study aimed to identify EMVI and assess its impact on survival and recurrences in esophageal squamous cell carcinoma (ESCC). Retrospectively, we reviewed resection specimens of 147 locally advanced ESCC (pT3-T4aN0-3M0) patients who had a curative intended surgery alone at the Cancer Hospital of Shantou University from March 2009 to December 2013. After confirming pT≥3 in hematoxylin-eosin tumor slides, EMVI was evaluated by Verhoeff and Caldesmon staining. The impact of EMVI with other clinicopathological characteristics and survival were analyzed using the χ 2 test, Cox regression, and Kaplan-Meier method. EMVI was present in 30.6% (45/147) of the P ≥T3 ESCCs and associated with lymph-vascular invasion and poor differentiation grade ( P <0.05). Disease-free survival and overall survival in patients with EMVI-absent tumors were about 2.0 times longer than in those with EMVI-present tumors. In pN0 patients, EMVI-presence was associated with poor overall survival (HR 4.829, 95% CI 1.434-16.26, P =0.003) and Disease-free Survival (HR 4.026, 95% CI 0.685-23.32, P =0.018). In pN1-3 patients, EMVI had no additional effect on survival. Conclusions EMVI has an independent adverse prognostic effect on survival in ESCC patients after surgery alone. EMVI should be included in pathology reports as it might contribute to identify high-risk patients for potential additional treatment.
外膜静脉侵犯（EMVI）在食管癌中的作用仍不清楚。本研究旨在确定 EMVI，并评估其对食管鳞状细胞癌（ESCC）生存和复发的影响。我们回顾性分析了 2009 年 3 月至 2013 年 12 月在汕头大学癌症医院接受根治性手术的 147 例局部晚期 ESCC（pT3-T4aN0-3M0）患者的切除标本。在苏木精-伊红肿瘤切片中确认 pT≥3 后，通过 Verhoeff 和 Caldesmon 染色评估 EMVI。采用 χ 2 检验、Cox 回归和 Kaplan-Meier 方法分析 EMVI 与其他临床病理特征和生存的关系。EMVI 存在于 45/147 例 pT≥3 的 ESCC 中，与淋巴血管侵犯和低分化程度相关（P<0.05）。无复发生存和总生存时间方面，无 EMVI 肿瘤患者约为有 EMVI 肿瘤患者的 2.0 倍。在 pN0 患者中，EMVI 存在与总生存不良相关（HR 4.829，95%CI 1.434-16.26，P=0.003）和无复发生存（HR 4.026，95%CI 0.685-23.32，P=0.018）。在 pN1-3 患者中，EMVI 对生存无额外影响。结论：EMVI 对单独手术后 ESCC 患者的生存有独立的不良预后作用。EMVI 应包含在病理报告中，因为它可能有助于识别潜在额外治疗的高危患者。
