Histopathological Factors for Evaluation of the Malignant Potential of Esophageal T1b-SM Squamous Cell Carcinoma:Tumor Budding as a Predictive Factor of Nodal Metastasis Tetsuo Nemoto 1 , Kazuhiro Fuchinoue 2 , Hideaki Shimada 3,4 , Kazutoshi Shibuya 5 , Jun Ohara 1 , Mayumi Homma 1 , Kaori Kameyama 1 1Department of Diagnostic Pathology, Showa University Northern Yokohama Hospital, Yokohama, Japan 2Department of Gastroenterology, Toho University Omori Medical Center, Tokyo 3Department of Clinical Oncology, Graduate School of Medicine, Toho University, Tokyo 4Department of Gastrointestinal Surgery, Toho University Omori Medical Center, Tokyo 5Department of Surgical Pathology, Toho University, School of Medicine, Tokyo Keyword: esophagus , T1b-SM , squamous cell carcinoma , tumor budding , immunohistochemistry pp.1226-1236
Published Date 2020/9/25
DOI https://doi.org/10.11477/mf.1403202133
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 Histopathological evaluation of malignant potential, including prediction of lymph node metastasis, is important in cases of T1b-SM esophageal squamous cell carcinoma. To date, a number of pathological predictors of lymph node metastasis have been proposed, namely, depth of invasion, vascular invasion, cellular atypia, degree of differentiation, and infiltrating proliferation with small cancer cell cluster formation. Of these putative predictive factors, the formation of small cell clusters, known as “tumor budding”, has received considerable attention, with a consensus being reached regarding its predictive importance and standardization of a reliable evaluation approach.

 In this study, we show the usefulness of tumor budding as a predictor of lymph node metastasis in superficial esophageal cancer by establishing appropriate threshold values and demonstrating the advantage of immunostaining cancer cells. Further, we outline the potential application of molecular alterations known in esophageal squamous cell carcinoma for the evaluation of malignancy.

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