A comparative analysis of clinicopathological factors between esophageal small cell and basaloid squamous cell carcinoma

Ishida, Hirotaka; Kasajima, Atsuko; Onodera, Yu; Konno, Tasuku; Maruyama, Shota; Okamoto, Hiroshi; Sato, Chiaki; Heishi, Takahiro; Sakurai, Tadashi; Taniyama, Yusuke; Takahashi, Masanobu; Fujishima, Fumiyoshi; Jingu, Keiichi; Ishioka, Chikashi; Sasano, Hironobu; Kamei, Takashi

doi:10.1097/md.0000000000014363

Cited by 10 publications

(9 citation statements)

References 22 publications

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“…We studied 97 esophageal carcinoma cases: 15 small-cell carcinomas and 82 high-grade squamous cell carcinomas. The high-grade squamous cell carcinomas, termed based on their aggressive clinical nature, consisted of 46 poorly differentiated and 36 basaloid squamous cell carcinomas [ 3 , 5 ]. All the specimens were surgically resected between 1988 and 2017.…”

Section: Methodsmentioning

confidence: 99%

“…The specimens of esophageal small-cell carcinoma were retrieved from six Japanese institutions listed in a previous study [ 6 ], and high-grade squamous cell carcinomas from a single institution (Tohoku University Hospital, Sendai, Japan). The clinical data of the patients were reported in the previous studies to compare the outcomes of small-cell carcinoma and basaloid squamous cell carcinoma patients, as well as SOX2 and Rb1 expression in small-cell carcinomas [ 3 , 6 ]. All the specimens were independently reviewed by three pathologists (AK, FF, and HS).…”

Section: Methodsmentioning

confidence: 99%

“…Approximately 85% of esophageal neoplasms are squamous cell carcinomas in East Asian countries [ 1 , 2 ]. Among these patients, histological differentiation and types are associated with clinical outcome of the patients; in particular, poorly differentiated or basaloid squamous cell carcinomas of the esophagus have significantly worse prognosis than well- to moderately differentiated ones [ 3 – 5 ]. In addition, esophageal small-cell carcinomas, which account for 0.05–3.1% of all esophageal malignancies [ 1 , 6 , 7 ], are known to be highly aggressive [ 3 , 6 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

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p16 in highly malignant esophageal carcinomas: the correlation with clinicopathological factors and human papillomavirus infection

et al. 2020

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Abstractp16 is generally considered to be a surrogate maker of human papillomavirus (HPV) infection and also a predictive marker of favorable clinical outcome of patients with squamous cell carcinoma of the oropharynx. p16 overexpression is also known to be induced by deregulation of RB1 in neuroendocrine carcinomas. In highly malignant esophageal neoplasms, however, the status of p16 has remained largely unknown. We immunolocalized p16 and Rb1 in 82 surgically resected esophageal high-grade squamous cell carcinomas (46 poorly differentiated and 36 basaloid squamous cell carcinomas) and 15 esophageal small-cell carcinomas in order to clarify the clinical and biological significance of p16. p16 immunoreactivity was detected in 7/82 (9%) high-grade squamous cell carcinomas and 15 (100%) small-cell carcinomas. p16 immunoreactivity was significantly associated with Rb1 protein loss in both groups (P < 0.001). HPV was detected in none of the p16-positive cases examined. Clinical outcome of the p16-positive high-grade squamous cell carcinomas was not different from that of the p16-negative counterparts (P = 0.687) but significantly better than those with the small-cell carcinomas (P = 0.023). p16 was therefore considered to be induced through an inactivation of the RB1 signaling pathway and not through HPV infection in highly malignant esophageal neoplasms. Nevertheless, patients’ clinical outcome of these neoplasms significantly differs; therefore, small-cell carcinomas have to be carefully differentiated from other neoplasms. In addition, p16 overexpression is not predictive of favorable clinical outcome in high-grade squamous cell carcinomas of the esophagus.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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p16 in highly malignant esophageal carcinomas: the correlation with clinicopathological factors and human papillomavirus infection

et al. 2020

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“…Ishida et al revealed that the ulcerative or diffusely infiltrative microscopic features (P=0.017), high T stage (P=0.034), N stage (P=0.022) and location of tumor (middle segment) (P=0.035) seemed to be favorable prognostic factors after reviewing 29 ESCC patients. 26 Song et al demonstrated that high TNM stage (P=0.001) and vessel involvement (P=0.019) predicted worse survival by retrospectively analyzing 151 patients. 4 In 2019, Chen et al enrolled 42 ESCC patients who received radiotherapies and found that ESCC patients could benefit from radiotherapy and a higher dose of radiotherapy predicted better OS in limited stage ESCC.…”

Section: Discussionmentioning

confidence: 99%

<p>Low Albumin to Fibrinogen Ratio Predicts Poor Overall Survival in Esophageal Small Cell Carcinoma Patients: A Retrospective Study</p>

Wang

Chang

et al. 2020

CMAR

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To explore the prognostic value of albumin to fibrinogen ratio (AFR) in patients with esophageal small cell carcinoma (ESCC). Patients and Methods: Patients diagnosed with ESCC in West China Hospital from June 1, 2010, to July 31, 2019, were retrospectively reviewed. The AFR was defined as the ratio between the serum albumin level and fibrinogen level. The receiver operating characteristic curves were conducted to determine optimal cutoff values for survival prediction. Univariate and multivariate cox regression analyses were performed to clarify independent prognostic risk factors. Results: A total of 88 ESCC patients were enrolled in our study with the median follow-up time of 6 months (range 1-91 months). In the univariate analysis, the node metastasis, extraesophageal metastasis status, tumor-node-metastasis (TNM) stage and AFR were found to be potentially related with overall survival (OS) of ESCC patients. After the multivariate analysis, AFR [hazard ratio (HR)=3.487, 95% confidence interval (CI): 1.179-10.312; P=0.024] and TNM stage (HR=6.044, 95% CI: 1.045-34.974; P=0.045) were testified to be independent prognostic factors and low AFR (≤12.36) level was significantly associated with poor OS in ESCC patients. Conclusion: The current study reported that AFR could serve as a novel prognostic indicator in ESCC and patients with AFR≤12.36 were more likely to have poor prognosis.

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“…Basaloid squamous cell carcinoma consists of basaloid-shaped cells harboring roundto-oval-shaped nuclei, dense hyperchromatic nuclei and basophilic scant cytoplasm presenting a high nucleus-cytoplasm ratio (Odze et al 2019). The clinical outcome of patients with basaloid squamous cell carcinoma is well known to be significantly much worse than that of patients with conventional squamous cell carcinoma (Chen et al 2012;Imamhasan et al 2012;Ishida et al 2019). Esophageal carcinosarcoma, known as spindle cell squamous cell carcinoma, is also a rare neoplasm that accounts for 0.1%-2.8% of all esophageal malignancies (Wang et al 2013;Tachimori et al 2017;Odze et al 2019).…”

Section: Discussionmentioning

confidence: 99%

Esophageal Carcinosarcoma with Basaloid Squamous Cell Carcinoma: A Case Report and Review of the Literature

Ishida

Fujishima

Onodera

et al. 2019

Tohoku J. Exp. Med.

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Esophageal carcinosarcoma is a rare tumor composed of neoplastic squamous epithelium and sarcomatous spindle cells. The origin of spindle cells remains unknown; however, the majority of sarcomatous components are currently considered to be derived from existing carcinomatous cells via epithelial-mesenchymal transition (EMT). We report a case of esophageal carcinosarcoma harboring basaloid squamous cell carcinoma successfully treated with preoperative chemotherapy. A 78-year-old man complaining dysphagia was diagnosed as esophageal carcinosarcoma. After two courses of preoperative chemotherapy with cisplatin and 5-fluorouracil, curative esophagectomy with lymph node dissection was performed thoracoscopically. Histopathological findings of the resected specimen revealed the mixture of basaloid squamous cell carcinoma and sarcomatous spindle cells. A transitional zone between both components was also detected. As fibrosis was identified around both two components, the findings indicated that both carcinomatous and sarcomatous neoplasms disappeared by preoperative chemotherapy. Final pathological diagnosis was esophageal carcinosarcoma with basaloid squamous cell carcinoma. No recurrent lesions have been detected for 25 months after the surgery. Sarcomatous spindle cells could be derived from the components of basaloid squamous cell carcinoma in our present case due to the presence of histological transition between two components. In addition, the marked immunoreactivity of vimentin (an EMT marker) detected in the tumor cells of basaloid squamous cell carcinoma could be consistent with the concept of monoclonal origin via EMT. The regimen targeting squamous cell carcinoma could also be effective in the treatment of sarcomatous components. Preoperative therapy might achieve the improvement of clinical outcome of patients with esophageal carcinosarcoma.

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A comparative analysis of clinicopathological factors between esophageal small cell and basaloid squamous cell carcinoma

Abstract: Supplemental Digital Content is available in the text

Cited by 10 publications

References 22 publications

p16 in highly malignant esophageal carcinomas: the correlation with clinicopathological factors and human papillomavirus infection

p16 in highly malignant esophageal carcinomas: the correlation with clinicopathological factors and human papillomavirus infection

<p>Low Albumin to Fibrinogen Ratio Predicts Poor Overall Survival in Esophageal Small Cell Carcinoma Patients: A Retrospective Study</p>

Esophageal Carcinosarcoma with Basaloid Squamous Cell Carcinoma: A Case Report and Review of the Literature

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