Kazuhiro Fuchinoue1,2, Tetsuo Nemoto3, Hideaki Shimada4,5,6, Naobumi Tochigi7, Yoshinori Igarashi1, Satoshi Yajima8, Takashi Suzuki8, Yoko Oshima8, Kazutoshi Shibuya7. 1. Department of Gastroenterology, School of Medicine, Toho University, Tokyo, Japan. 2. Department of Clinical Oncology, Graduate School of Medicine, Toho University, Tokyo, Japan. 3. Department of Pathology, Showa University Northern Yokohama Hospital, Yokohama, Japan. 4. Department of Clinical Oncology, Graduate School of Medicine, Toho University, Tokyo, Japan. hideaki.shimada@med.toho-u.ac.jp. 5. Department of Gastroenterological Surgery, School of Medicine, Toho University, Tokyo, Japan. hideaki.shimada@med.toho-u.ac.jp. 6. Department of Surgery, Toho University Graduate School of Medicine, Tokyo, Japan. hideaki.shimada@med.toho-u.ac.jp. 7. Department of Surgical Pathology, School of Medicine, Toho University, Tokyo, Japan. 8. Department of Gastroenterological Surgery, School of Medicine, Toho University, Tokyo, Japan.
Abstract
BACKGROUND: Tumor budding is known predictors of lymph node metastasis from esophageal squamous cell carcinoma. However, it is not easy to detect such small cell clusters on hematoxylin-eosin (HE) staining. Therefore, we evaluated tumor budding using immunohistochemistry (IHC) for epithelial cell markers. METHOD: We analyzed tumor budding in 50 cases of superficial esophageal squamous cell carcinoma. We evaluated the impact of clinicopathological factors and tumor budding to predict lymph node metastasis. A total of 565 tumor sections were assessed using HE staining and IHC for cytokeratin 5/6. RESULTS: Based on receiver operating characteristic curves, the cut-off values for high-grade tumor budding evaluated using HE staining or IHC were 2 and 11, respectively. High-grade tumor budding evaluated using HE staining (P = 0.007) and IHC (P ≤ 0.001) were significantly correlated with lymph node metastasis. For tumors with pT1a-MM to pT1b-SM1, high-grade tumor budding evaluated using IHC was correlated with lymph node metastasis (P = 0.050). CONCLUSIONS: Tumor budding was significantly associated with lymph node metastasis. The optimal cut-off values of tumor budding on HE staining and tumor budding on IHC were 2 and 11, respectively. Even though both tumor budding on HE staining and tumor budding on IHC were significantly associated with lymph node metastasis, tumor budding on IHC tend to be more associated with lymph node metastasis.
BACKGROUND:Tumor budding is known predictors of lymph node metastasis from esophageal squamous cell carcinoma. However, it is not easy to detect such small cell clusters on hematoxylin-eosin (HE) staining. Therefore, we evaluated tumor budding using immunohistochemistry (IHC) for epithelial cell markers. METHOD: We analyzed tumor budding in 50 cases of superficial esophageal squamous cell carcinoma. We evaluated the impact of clinicopathological factors and tumor budding to predict lymph node metastasis. A total of 565 tumor sections were assessed using HE staining and IHC for cytokeratin 5/6. RESULTS: Based on receiver operating characteristic curves, the cut-off values for high-grade tumor budding evaluated using HE staining or IHC were 2 and 11, respectively. High-grade tumor budding evaluated using HE staining (P = 0.007) and IHC (P ≤ 0.001) were significantly correlated with lymph node metastasis. For tumors with pT1a-MM to pT1b-SM1, high-grade tumor budding evaluated using IHC was correlated with lymph node metastasis (P = 0.050). CONCLUSIONS:Tumor budding was significantly associated with lymph node metastasis. The optimal cut-off values of tumor budding on HE staining and tumor budding on IHC were 2 and 11, respectively. Even though both tumor budding on HE staining and tumor budding on IHC were significantly associated with lymph node metastasis, tumor budding on IHC tend to be more associated with lymph node metastasis.
Authors: Alessandro Lugli; Inti Zlobec; Martin D Berger; Richard Kirsch; Iris D Nagtegaal Journal: Nat Rev Clin Oncol Date: 2020-09-08 Impact factor: 66.675