PhD Scientific Days 2024

Budapest, 9-10 July 2024

Poster Session J - Pathological and Oncological Sciences 1.

Different Infiltration Patterns on the Invasion Front Can Predict the Presence of Lymph Node Metastasis in Esophageal Squamous Cell Carcinoma and Adenocarcinoma


Éva Kocsmár1, Ákos Jakab1, Levente Zarándy1, Tibor Várkonyi1, István Kenessey1, Ildikó Kocsmár2, Attila Szijártó3, András Kiss1, Tamás Vass3, Gábor Lotz1
1: Department of Pathology, Forensic and Insurance Medicine, Semmelweis University
2: Department of Urology, Semmelweis University
3: Department of Surgery, Transplantation and Interventional Gastroenterology, Semmelweis University

Text of the abstract

Aims: Esophageal cancer is one of the leading causes of cancer death worldwide. Our aim was to investigate the prognostic significance of histological features at the invasion front, such as tumor budding (TB), poorly differentiated cluster (PDC) and Stroma Areactive Invasion Front Areas (SARIFA) in esophageal squamous cell carcinoma (ESQCC) and adenocarcinoma (EAC).
Methods: The H&E stained slides of 100 patients (43 EAC and 57 ESQCC) were examined. TB was defined as an isolated tumor cell or a group of up to four cells, while PDC was a group of five or more cells. Patients were classified as TB low / high, PDC low / high. The co-presence of SARIFA (tumor-associated fat cells without desmoplastic stromal reaction; -/+) in the invasive front area was also assessed.
Results: In EAC, SARIFA+ status is significantly more frequent than in ESQCC (p=0.004). In ESQCC, no correlation was found between TB/PDC/SARIFA statuses, but the presence of SARIFA was significantly more frequent in EAC patients with higher number of small cell clusters (TBs and low cell count PDCs) compared to cases showing fewer, low cell count tumor cell clusters (p<0.001). A high TB/SARIFA+ status was more frequent in EAC cases with higher T stage (p=0.01; p=0.001), but no such association was confirmed in ESQCC. In multivariate analysis with backward selection, high TB status in ESQCC (p<0.001) and SARIFA+ status in EAC (p=0.01) were found to be independent prognostic factors for lymph node metastasis.
Conclusion: Although the prognosis of esophageal cancer is generally poor, so far only a few tissue markers of prognostic significance have been identified. Our results demonstrate that the invasion fronts of ESQCC and EAC show histologically distinct infiltrative patterns. Lymph node metastases, which play a crucial role in tumor management, are associated with a high TB status in ESQCC and with the presence of the recently described SARIFA in EAC.
Funding: Supported by grants K_22 142604 (NKFIH-Hungary) and ÚNKP-23-4-II-SE-24 New National Excellence Program of the Ministry for Culture and Innovation from the source of National Research, Development and Innovation Fund, Hungary.