Assessment of clinical outcome in patients with esophageal squamous cell carcinoma using TNM classification score and molecular biological classification.
BACKGROUND
The aim of this study was to assess the clinical outcome in patients with esophageal squamous cell carcinoma (ESCC) by using molecular biological classification based on immunohistochemical analysis in addition to tumor, node, metastasis system (TNM) classification.


METHODS
Samples from 71 patients with ESCC who underwent surgery were analyzed immunohistochemically. Cyclin B1, E-cadherin, Bag-1, and heat-shock protein 70 were selected as the molecular biological parameters. The utility of molecular biological classification on clinical impact was examined and compared with TNM classification.


RESULTS
Three patients were diagnosed as stage 0, 14 as stage I, 20 as stage II, 19 as stage III, and 15 as stage IV by TNM classification. Thirteen patients were classified as stage 0, 17 as stage I, 21 as stage II, 18 as stage III, and 2 as stage IV by molecular biological classification. Molecular biological stage (P < .0001) and TNM stage (P < .0001) were statistically significant prognostic parameters in univariate analysis. Twenty (28.2%) of 71 patients were assigned to the same stage by both classifications, and a significant correlation was identified between the two classifications (P = .0002). Molecular biological classification (P < .01) and TNM classification (P < .0001) were independent prognostic parameters in multivariate analysis. Combined TNM and molecular biological classification accurately reflected clinical outcome (P < .0001).


CONCLUSIONS
Molecular biological classification combined with TNM classification is useful for assessing the prognosis of patients with ESCC.
Takeno
Shinsuke
S
Department of Oncological Science (Surgery II), Faculty of Medicine, Oita University, Idaigaoka 1-1, Hasama-machi, Yufu-City, Oita 879-5593, Japan. takeno@med.oita-u.ac.jp
Noguchi
Tsuyoshi
T
Takahashi
Yoshiaki
Y
Fumoto
Shoichi
S
Shibata
Tomotaka
T
Kawahara
Katsunobu
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism*; D015820:Cadherins / Q000378:metabolism; D002294:Carcinoma, Squamous Cell / Q000145:classification* / Q000378:metabolism / Q000473:pathology; D019926:Cyclin B / Q000378:metabolism; D056744:Cyclin B1; D004268:DNA-Binding Proteins / Q000378:metabolism; D004938:Esophageal Neoplasms / Q000145:classification* / Q000378:metabolism / Q000473:pathology; D005260:Female; D018840:HSP70 Heat-Shock Proteins / Q000378:metabolism; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D015996:Survival Rate; D014157:Transcription Factors / Q000378:metabolism
C091732:BCL2-associated athanogene 1 protein; D014408:Biomarkers, Tumor; C534699:CCNB1 protein, human; D015820:Cadherins; D019926:Cyclin B; D056744:Cyclin B1; D004268:DNA-Binding Proteins; D018840:HSP70 Heat-Shock Proteins; D014157:Transcription Factors