Jakab Ákos, Zarándy Levente, Kocsmár Ildikó, Várkonyi Tibor, Kenessey István, Szijártó Attila, Kiss András, Vass Tamás, Lotz Gábor, Kocsmár Éva
Department of Pathology, Forensic and Insurance Medicine, Semmelweis University, Üllői Str. 93, H-1091 Budapest, Hungary.
Department of Urology, Semmelweis University, Üllői Str. 78/b, H-1082 Budapest, Hungary.
Cancers (Basel). 2024 Sep 13;16(18):3144. doi: 10.3390/cancers16183144.
Both esophageal squamous cell carcinoma (ESQCC) and adenocarcinoma (EAC) are known to have poor prognosis. We aimed to investigate the invasion front areas of 57 ESQCC and 43 EAC cases to find histological signs of metastatic progression. Tumor cell clusters with different cell counts, including tumor buds (TBs) and poorly differentiated clusters (PDCs), were assessed. The presence of the recently described Stroma AReactive Invasion Front Area (SARIFA) phenomenon, which defines a direct contact between tumor cells and adipocytes, was more frequently observed in EAC than in ESQCC ( = 0.004). In adenocarcinomas, a higher prevalence of SARIFA was observed in tumors with a higher number of small clusters (TBs and small PDCs; < 0.001); furthermore, both the high number of TBs ( = 0.016) and the presence of SARIFA ( = 0.001) correlated with a higher pT stage. SARIFA positivity in EAC ( = 0.011) and high TB in ESQCC ( = 0.0006) were found to be independent prognostic factors for lymph node metastases. Moreover, in ESQCC, the higher absolute number of both TBs and PDCs was associated with shorter overall survival ( = 0.0269 and = 0.0377, respectively). Our results suggest that the histological subtypes of esophageal cancer behave differently, namely, that different features of the invasion front are of prognostic significance.
食管鳞状细胞癌（ESQCC）和腺癌（EAC）均已知预后较差。我们旨在研究57例ESQCC和43例EAC病例的浸润前沿区域，以寻找转移进展的组织学迹象。评估了具有不同细胞数量的肿瘤细胞簇，包括肿瘤芽（TBs）和低分化簇（PDCs）。最近描述的基质反应性浸润前沿区域（SARIFA）现象，即肿瘤细胞与脂肪细胞之间的直接接触，在EAC中比在ESQCC中更频繁地观察到（ = 0.004）。在腺癌中，在具有较高数量小簇（TBs和小PDCs）的肿瘤中观察到更高的SARIFA患病率（ < 0.001）；此外，高数量的TBs（ = 0.016）和SARIFA的存在（ = 0.001）均与更高的pT分期相关。EAC中的SARIFA阳性（ = 0.011）和ESQCC中的高TB（ = 0.0006）被发现是淋巴结转移的独立预后因素。此外，在ESQCC中，TBs和PDCs的更高绝对数量均与较短的总生存期相关（分别为 = 0.0269和 = 0.0377）。我们的结果表明，食管癌的组织学亚型表现不同，即浸润前沿的不同特征具有预后意义。
