AE1 cytokeratin reaction patterns in different differentiation states of squamous cell carcinoma of the esophagus.

Anticytokeratin antibody AE1 was studied immunohistochemically in 56 surgical specimens of esophageal carcinoma. Relationships between morphologic characteristics and AE1 reaction patterns were analyzed in carcinomas and adjacent epithelium. Infiltrating carcinomas had three types of AE1 patterns that paralleled degrees of differentiation. Type 1 pattern was present in well-differentiated carcinomas characterized by cytoplasmic staining of polyhedral cells. Types 2 and 3 were seen in poorly differentiated and undifferentiated carcinomas in different percentages, characterized by all cancer cells stained, with cellular membrane and cytoplasm stained or all unstained, respectively. In normal esophageal epithelium, basal cells were the major population that was AE1 positive. In hyperplasia basal cells showed two kinds of changes, either reduced/lost AE1 staining accompanied by AE1 expression in spinous cells or retained/increased AE1 reactivity. In dysplasia and carcinoma in situ, abnormal cells had reaction patterns in which they lost or increased AE1 expression. Findings indicate that different degrees of differentiation of infiltrating esophageal carcinoma cells have differing expressions of cytokeratins and that monoclonal antibody AE1 can serve as a biomarker identifying early abnormalities in esophageal epithelial cells having increased predisposition to malignancy. Molecular mechanisms of AE1 cytokeratin expression in esophageal epithelium are also discussed.