Qi Xing, Zuo Zhenxiang, Yu Bin, Zhang Huimin, Cui Xiujie, Li Guangchun, Wu Honglei
Department of Gastroenterology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
Department of Hematology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
Front Oncol. 2025 Jul 30;15:1512433. doi: 10.3389/fonc.2025.1512433. eCollection 2025.
Superficial esophageal squamous cell carcinoma (SESCC) is defined as neoplastic lesions limited to the mucosa or submucosa regardless of the nodal status. The infiltrative growth pattern (INF) has been implicated in tumor aggressiveness and prognosis in various cancers, but the application research of INF in SESCC is still unclear. We aimed to investigate the association between INF types and clinicopathological features in SESCC.
We retrospectively analyzed 368 SESCC patients who underwent endoscopic submucosal dissection and precisely defined INF classification from 2014 to 2023. INF was classified as INFa/b/c per Japanese Esophageal Society guidelines. Clinicopathological characteristics were compared across INF types using univariate analysis. Significant variables from univariate analysis were included in multivariate logistic regression to identify independent predictors of INF types.
Univariate analysis revealed that the INF of tumor was associated with tumor size, gross morphology, intraepithelial papillary capillary loop (IPCL), infiltration depth, lymphovascular invasion, and vertical positive margins (All < 0.05). Multivariate logistic regression demonstrated that tumor size (=0.28, P=0.004; OR=1.32, 95%CI:1.09-1.59), IPCL (=0.81, P=0.004; OR=2.24, 95%CI:1.30-3.85), and infiltration depth (=0.81, P=0.017; OR=2.24, 95%CI:1.15-4.35) were significantly correlated with INFb, while lymphovascular invasion (=8.77, P=0.007; OR=6456.93, 95%CI:10.96-3803785.49) as an independent risk factor for INFc.
Increased tumor size, presence of IPCL type B2, and depressed gross morphology were more indicative of INFc-type SESCC. Compared with INFa and INFb, INFc type SESCC has deeper infiltration depth and is more likely to have lymphovascular invasion and positive postoperative resection margins. Therefore, careful endoscopic visualization of tumor size, IPCL, and gross morphology can improve the prediction of INF and tumor status, facilitating informed preoperative selection of surgical approach and subsequent postoperative treatments.
浅表性食管鳞状细胞癌（SESCC）被定义为肿瘤性病变局限于黏膜或黏膜下层，无论有无淋巴结转移情况。浸润性生长模式（INF）与多种癌症的肿瘤侵袭性和预后相关，但INF在SESCC中的应用研究仍不明确。我们旨在研究SESCC中INF类型与临床病理特征之间的关联。
我们回顾性分析了2014年至2023年期间接受内镜黏膜下剥离术的368例SESCC患者，并根据日本食管癌学会指南精确界定INF分类。INF根据日本食管癌学会指南分为INFa/b/c。使用单因素分析比较不同INF类型的临床病理特征。单因素分析中的显著变量纳入多因素逻辑回归，以确定INF类型的独立预测因素。
单因素分析显示，肿瘤的INF与肿瘤大小、大体形态、上皮内乳头毛细血管袢（IPCL）、浸润深度、脉管侵犯及垂直切缘阳性相关（均P<0.05）。多因素逻辑回归显示，肿瘤大小（β=0.28，P=0.004；OR=1.32，95%CI：1.09-1.59）、IPCL（β=0.81，P=Q004；OR=2.24，95%CI：1.30-3.85）和浸润深度（β=0.81，P=0.017；OR=2.24，95%CI：1.15-4.35）与INFb显著相关，而脉管侵犯（β=8.77，P=0.007；OR=6456.93，95%CI：10.96-3803785.49）是INFc的独立危险因素。
肿瘤大小增加、存在B2型IPCL及凹陷性大体形态更提示为INFc型SESCC。与INFa和INFb相比，INFc型SESCC浸润深度更深，更易出现脉管侵犯及术后切缘阳性。因此，仔细内镜观察肿瘤大小、IPCL及大体形态可改善对INF及肿瘤状态的预测，有助于术前明智地选择手术方式及后续术后治疗。
