Publication: Molecular markers predicting lymph node metastasis in early esophageal cancer
Authors
Plum, Patrick S. ; Warnecke-Eberz, Ute ; Dhaouadi, Oulfa ; Alakus, Hakan ; Drebber, Uta ; Metzger, Ralf ; Prenze, Klaus L. ; Hölscher, Arnulf H. ; Bollschweiler, Elfriede
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Publisher
F. Hernández y Juan F. Madrid. Universidad de Murcia: Departamento de Biología Celular e Histología
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DOI
10.14670/HH-11-618
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info:eu-repo/semantics/article
Description
Abstract
y. AIMS: The aim of this study was to identify
molecular markers predicting depth of tumor infiltration
and presence of lymph node metastasis in early
esophageal cancer.
METHODS: Between 1996 and 2004, 67 patients
with pT1 esophagus cancer underwent esophagectomy.
Resected tumors and lymph nodes were analyzed by
immunohistochemistry for tissue infiltration, lymph
node metastasis (LNM), micrometastasis and
extracapsular lymph node infiltration (ELNI). We
focused on MMP-2 (matrix-metalloproteinase-2), TIMP2 (tissue inhibitor of metalloproteinase-2), PIM-1 and
survivin as the most promising marker candidates. The
data was correlated with the patients’ long term followup (median follow-up time 11.4 years).
RESULTS: We found 22 pT1a and 45 pT1b
carcinomas. None of the mucosal carcinomas, but 58%
(26 patients) of the submucosal carcinomas showed
lymph node metastasis or micrometastasis. The rate of
LNM positively correlated with the depth of tumor
infiltration (23% LNM in sm1 tumors and 82% LNM in
sm3 tumors). Low grade PIM-1 expression (<30%) was
significantly associated with occurrence of LNM
(p=0.034) while high expression TIMP-2 (>70%) were
detected in submucosal tumors. Logistic regression
analysis revealed PIM-1 and Grading G3 as independent
risk factors for LNM (p<0.001). Survival of patients
with micrometastasis was comparable to those with
LNM (median survival: 5.05 years versus 5.52 years).
Patients with ELNI had the worst prognosis (median
survival: 1.7 years).
CONCLUSIONS: PIM-1 is a promising marker for
prediction of lymph node metastasis in early esophagus
cancer. Extracapsular lymph node infiltration has an
independent worse prognostic impact.
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Citation
Histology and histopathology, Vol. 30, nº10, (2015)
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