[A histopathologic and immunohistochemical study of prognostic factors in esophageal squamous cell carcinoma].

OBJECTIVE: To investigate the prognostic value of various histopathological features and expression of immuno-phenotypes in esophageal squamous cell carcinoma (ESCC). METHODS: The tumor samples from 97 primary ESCC patients with potentially curative resection were evaluated for the following parameters: tumor size, grade of differentiation, pattern of invasion, depth of invasion, degree of lymphocyte infiltration, lymph node metastasis, TNM stage and p53, EGFR, c-erbB-2, nm23, cathepsin D protein expression. The prognostic impact of these parameters were analyzed by univariate and multivariate survival analyses. RESULTS: In the univariate Kaplan Meier analysis, poor differentiation, infiltrating growth pattern, invasion reaching adventitia, absent lymphocytic infiltration, lymph node metastasis, high staging, EGFR positive expression and nm23 negative expression were all associated with lower survival rate (Log-rank test, P < 0.05, respectively). However, the multivariate Cox analysis demonstrated that only pattern of invasion (RR = 2.000), degree of lymphocyte infiltration (RR = 0.509), TNM stage (RR = 1.733), EGFR expression (RR = 1.812) and c-erbB-2 expression (RR = 2.364) were significant prognostic factors (P < 0.05, respectively). CONCLUSION: For ESCC, the pattern of invasion, degree of lymphocyte infiltration, EGFR and c-erbB-2 protein expression had independent prognostic values as well as the TNM stage. Comprehensive analysis of these parameters can be helpful to identify biological behavior of ESCC and predict more accurately the prognosis of patients with ESCC.