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Invasive features of superficial oesophageal squamous cell carcinoma—analysis of risk factors for lymph node metastasis

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Abstract

There are currently no studies that have examined the clinicopathological factors in detail, including the histological images of the invasive front, and the risk of lymph node metastasis (LNM) in superficial oesophageal squamous cell carcinoma (SESCC). This study aimed to develop an algorithm that contributes to a better assessment of the risk of LNM and recurrence in SESCC. Clinicopathological factors, such as submucosal (SM) invasion distance, were examined in 88 surgically resected cases of SESCC. An SM invasion distance of 600 μm was the statistically best customer value for LNM (p = 0.0043). To obtain a histological image of the invasive front, we evaluated modified tumour budding (MBD) by modifying the number of tumour foci constituent cells and foci in tumour budding. We also evaluated the smallest number of tumour foci. Using these factors, we developed an algorithm to predict the risk of LNM. The best algorithm was created using an SM invasion distance of 600 μm and an index of 5 or more foci consisting of five or fewer tumour cells in the MBD (MBD5 high-grade ≥ 5), which was also significantly associated with recurrence-free survival (p = 0.0305). Further study of the algorithm presented in this study is expected to improve the quality of life of patients by selecting appropriate additional treatments after endoscopic resection and appropriate initial treatment for SESCC.

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Data sharing is not applicable to this article as no new data were created or analysed in this study.

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Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing.

Compliance with ethical standards

All the performed procedures involving human participants were in accordance with the 1964 Helsinki Declaration and its later amendments.

Research involving animals

No animals were involved in the present study.

Informed consent

Informed consent was obtained from all the patients to anonymously report relevant clinical information and histologic findings related to their tumours.

Funding

This study was funded by Japan Society for the Promotion of Science (award number: 21K06922, recipient: Kenichi Ohashi).

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Authors and Affiliations

  1. Department of Human Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8510, Japan

    Yuki Kato, Takashi Ito, Kouhei Yamamoto, Asuka Furukawa, Hiroshi Shintaku, Kurara Yamamoto, Momoka Sakai, Yoshinobu Tomita & Kenichi Ohashi

  2. Division of Surgical Pathology, Tokyo Medical and Dental University Hospital, Tokyo, Japan

    Yusuke Chino & Keisuke Uchida

  3. Department of Esophageal Surgery, Tokyo Medical and Dental University Hospital, Tokyo, Japan

    Kenro Kawada

Authors
  1. Yuki Kato
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  2. Takashi Ito
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Correspondence to Kouhei Yamamoto.

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Supplementary Information

Additional file 1.

 Supplementary Figure. A study focusing on the characteristics of the smallest tumour foci. a the number of cells constituting the smallest tumour foci, b the smallest tumour foci size, c the distance from the main lesion of the smallest tumour foci.

Additional file 2.

 Supplementary Table 1. Histopathological features of invasive front as stratified by lymph node metastasis status.

Additional file 3.

 Supplementary Table 2. Cox proportional hazard regression model of clinicopathological features related to recurrence-free survival.

Additional file 4.

Supplementary Table 3. Risk assessment algorithm for lymph node metastasis in superficial oesophageal squamous cell carcinoma cases.

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Kato, Y., Ito, T., Yamamoto, K. et al. Invasive features of superficial oesophageal squamous cell carcinoma—analysis of risk factors for lymph node metastasis. Virchows Arch 483, 645–653 (2023). https://doi.org/10.1007/s00428-023-03582-x

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  • DOI: https://doi.org/10.1007/s00428-023-03582-x

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