Establishment of a comprehensive evaluation method for the invasion features of superficial esophageal squamous cell carcinoma and exploring its molecular basis

2023 Fiscal Year Final Research Report

• Project/Area Number: 21K06922
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 49020:Human pathology-related
• Research Institution: Tokyo Medical and Dental University
• Principal Investigator: Ohashi Kenichi 東京医科歯科大学, 大学院医歯学総合研究科, 教授 (40231203)
• Co-Investigator(Kenkyū-buntansha): 伊藤 崇 東京医科歯科大学, 大学院医歯学総合研究科, 助教 (20516314) ; 小林 大輔 東京医科歯科大学, 大学院医歯学総合研究科, 非常勤講師 (70361699)
• Project Period (FY): 2021-04-01 – 2024-03-31
• Keywords: 食道がん / 扁平上皮がん / 内視鏡切除 / リンパ節転移 / 簇出 / 上皮間葉転換

Outline of Final Research Achievements

We developed an algorithm to contribute to the appropriate assessment of the risk of lymph node metastasis (LNM) in superficial esophageal squamous cell carcinomas (SESCC) and investigated the relationship between invasive tip histology (budding) and EMT-related molecules. The histology of the invasive tip was evaluated by correcting the number of cells constituting the tumor cell budding and the number of the budding. The SM layer invasion distance of 600 μm was statistically the best value for LNM. The algorithm combining 600 μm invasion and 5 or more foci consisting of 5 or fewer tumor cells with budding was best and was also significantly associated with relapse-free survival. Tumor cell budding in SESCC correlated with decreased E-cadherin expression and increased Snail1 mRNA expression by immunohistochemistry and RT-PCR.

Free Research Field

人体病理学

Academic Significance and Societal Importance of the Research Achievements

本研究によって提案されたアルゴリズムを内視鏡切除検体に用いることにより、適切なLNM、再発のリスク予測やひいては適切な二期的な外科切除の選択が可能になるかもしれない。食道がんに対する手術療法、放射線化学療法は侵襲が強く、合併症の頻度も非常に高い。本来ならば追加治療な必要のない患者に対して、不必要な治療を避け、合併症の発生頻度を下げることが可能になる、さらにこれらのエビデンスを蓄積することにより臨床的なT1b-SMの症例に対する内視鏡的治療の拡大、患者QOLの向上が期待される。