title: Biological evaluation of undifferentiated carcinoma of the esophagus.
abstract: BACKGROUND
  Patients with undifferentiated carcinoma of the esophagus (UEC) are rare and have a poor prognosis compared with those with differentiated squamous cell carcinomas (DECs). We compared clinicopathological and biological features of UEC and DEC, with emphasis on markers for epithelial cell origin, proliferation, and cell-cell adhesion.
  
  
  METHODS
  Seven patients with UEC were compared with 21 with DEC. Immunohistochemical studies were performed by using monoclonal antibodies to cytokeratin, epithelial membrane antigen, p53, p21WAF1/CIP1, Ki-67, E-cadherin, desmoglein-1, and thrombomodulin.
  
  
  RESULTS
  Patients with UEC had a poorer prognosis because of hematogenous metastasis at the time of presentation (mean survival, 6.5 +/- 6.2 vs. 35.5 +/- 28.9 months; P < .05). Immunohistochemical findings for cytokeratin and epithelial membrane antigen suggest that some UECs had epithelial origins. The following immunohistochemical profile of UEC was consistent with its highly malignant properties: (1) reduced or negative expression of cell-cell adhesion molecules such as E-cadherin, desmoglein-1, and thrombomodulin, (2) high positive rate for p53 and Ki-67, and (3) negative expression of p21WAF1/CIP1.
  
  
  CONCLUSIONS
  The immunohistochemical findings for UEC showed its high cell-proliferative activity and a high potential for metastasis. Clinical features of UEC were supported by the results of immunohistochemical findings.
authors.affiliation: First Department of Surgery, Faculty of Medicine, Kagoshima University, Kagoshima City, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Matsumoto
authors.forename: S
authors.initials: S
authors.lastname: Natsugoe
authors.forename: S
authors.initials: S
authors.lastname: Nakashima
authors.forename: M
authors.initials: M
authors.lastname: Shimada
authors.forename: S
authors.initials: S
authors.lastname: Nakano
authors.forename: C
authors.initials: C
authors.lastname: Kusano
authors.forename: M
authors.initials: M
authors.lastname: Baba
authors.forename: S
authors.initials: S
authors.lastname: Takao
authors.forename: Y
authors.initials: Y
authors.lastname: Matsushita
authors.forename: T
authors.initials: T
authors.lastname: Aikou
mesh_terms: D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal; D014408:Biomarkers, Tumor / Q000032:analysis; D002277:Carcinoma / Q000473:pathology*; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D016009:Chi-Square Distribution; D004938:Esophageal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D018709:Statistics, Nonparametric; D016019:Survival Analysis
chemical_list: D000911:Antibodies, Monoclonal; D014408:Biomarkers, Tumor