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 (p= 0.004). In adenocarcinomas, a higher prevalence of SARIFA was observed in tumors with a higher number of small clusters (TBs and small PDCs;p< 0.001); furthermore, both the high number of TBs (p= 0.016) and the presence of SARIFA (p= 0.001) correlated with a higher pT stage. SARIFA positivity in EAC (p= 0.011) and high TB in ESQCC (p= 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 (p= 0.0269 andp= 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）与腺癌（EAC）均以预后不良著称。本研究旨在通过对57例ESQCC和43例EAC病例的浸润前沿区域进行分析，探寻与转移进展相关的组织学标志。我们评估了不同细胞数量的肿瘤细胞簇，包括肿瘤出芽（TBs）和低分化细胞簇（PDCs）。新近描述的间质反应性浸润前沿区域（SARIFA）现象——即肿瘤细胞与脂肪细胞直接接触——在EAC中的出现频率显著高于ESQCC（p=0.004）。在腺癌中，SARIFA更常见于具有较多小细胞簇（TBs及小型PDCs）的肿瘤（p<0.001）；此外，高数量的TBs（p=0.016）与SARIFA的存在（p=0.001）均与更高的pT分期相关。研究发现，EAC中的SARIFA阳性（p=0.011）和ESQCC中的高TBs数量（p=0.0006）是淋巴结转移的独立预后因素。此外在ESQCC中，TBs和PDCs的绝对数量增加均与较短的总生存期相关（分别为p=0.0269和p=0.0377）。我们的研究结果表明，食管癌的不同组织学亚型具有相异的生物学行为，即浸润前沿的不同特征具有特定的预后意义。
肿瘤(癌症)患者之家