title: Primary small cell carcinoma of the esophagus: clinicopathological and immunohistochemical features of 21 cases.
abstract: BACKGROUND
  Primary small cell carcinoma (SCC) of the esophagus is a rare and aggressive tumor with poor prognosis. In this study, we report the clinicopathological characteristics of 21 cases of small cell carcinoma of the esophagus treated at the Cancer Center of Sun Yat-Sen University, with particular focus on the histologic and immunohistochemical findings.
  
  
  METHODS
  Twenty-one patient records were reviewed including presenting symptoms, demographics, disease stage, treatment, and follow-up. Histologic features were observed and immunohistochemical detection of cytokeratin (CK), epithelial membrane antigen (EMA), neuron specific enolase (NSE), synaptophysin (Syn), chromogranin A (CgA), neuronal cell adhesion molecules (CD56), thyroid transcriptional factor-1 (TTF-1) and S100 protein (S100) was performed.
  
  
  RESULTS
  The median age of patients in the study was 56 years, with a male-to-female ratio of 3.2:1. Histologically, there were 19 "homogenous" SCC esophageal samples and 2 samples comprised of SCC and well-differentiated squamous cell carcinoma. The percentages of SCC samples with positive immunoreactivity were Syn 95.2%, CD56 76.2%, TTF-1 71.4%, NSE 61.9%, CgA 61.9%, CK 57.1%, EMA 61.9%, and S100 19.0%, respectively. The median patient survival time was 18.3 months after diagnosis. The 2-year survival rate was 28.6%.
  
  
  CONCLUSIONS
  Our study suggests that esophageal SCC has similar histology to SCC that arises in the lung compartment, and Chinese patients have a poor prognosis. Higher proportion of positive labeling of Syn, CD56, CgA, NSE, and TTF-1 in esophageal SCC implicate that they are valuably applied in differential diagnosis of the malignancy.
authors.affiliation: State Key Laboratory of Oncology in Southern China, Cancer Center, Sun Yat-Sen University, Guangzhou, China. yunjp@mail.sysu.edu.cn
authors.forename: Jing-Ping
authors.initials: JP
authors.lastname: Yun
authors.forename: Mei-Fang
authors.initials: MF
authors.lastname: Zhang
authors.forename: Jin-Hui
authors.initials: JH
authors.lastname: Hou
authors.forename: Qiu-Hong
authors.initials: QH
authors.lastname: Tian
authors.forename: Jia
authors.initials: J
authors.lastname: Fu
authors.forename: Xiao-Man
authors.initials: XM
authors.lastname: Liang
authors.forename: Qiu-Liang
authors.initials: QL
authors.lastname: Wu
authors.forename: Tie-Hua
authors.initials: TH
authors.lastname: Rong
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D018288:Carcinoma, Small Cell / Q000737:chemistry* / Q000175:diagnosis / Q000473:pathology*; D004938:Esophageal Neoplasms / Q000737:chemistry* / Q000175:diagnosis / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D014408:Biomarkers, Tumor