title: New invasive patterns as a prognostic factor for superficial esophageal cancer.
abstract: BACKGROUND
  Prognostic factors for superficial esophageal cancer cannot be limited to such factors as lymph node metastasis (N factor), depth of tumor invasion (T factor), and genetic alterations. The purpose of this study was to examine whether invasive growth patterns of tumors, such as infiltrative growth pattern c (INFc) and budding, represent new useful prognostic factors for superficial esophageal cancer.
  
  
  METHODS
  We investigated 87 cases of superficial esophageal cancer in patients treated with radical surgery. First, the invasive growth pattern of the tumor was pathologically evaluated based on the traditional infiltrative growth pattern (INF) classification. Next, new INF criteria were proposed, and the invasive pattern was re-evaluated. We also investigated budding (Bud) in the stroma of the invasive frontal lesion.
  
  
  RESULTS
  When the patients were divided into two groups, with and without an INFc component, the group with an INFc component had a poorer outcome than the group without an INFc component. When the group with an INFc component was defined as "new INFc", new INFc was correlated with the T factor (p = 0.006) and the ly factor (lymphatic invasion) (p = 0.041). Bud was correlated with the T factor (p = 0.001), the N factor (p = 0.030), and new INFc (p < 0.001). An analysis of survival revealed new INFc (p = 0.002) and Bud (p = 0.006) to be prognostic factors. The survival of the group with new INFc(+)/Bud(+) was poorer than that with new INFc(-)/Bud(-) (p = 0.007).
  
  
  CONCLUSIONS
  New INFc and Bud, which represent new invasive patterns, were prognostic factors for superficial esophageal cancer.
authors.affiliation: Department of Gastroenterological Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
authors.forename: Eisuke
authors.initials: E
authors.lastname: Ito
authors.forename: Soji
authors.initials: S
authors.lastname: Ozawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kijima
authors.forename: Akihito
authors.initials: A
authors.lastname: Kazuno
authors.forename: Takayuki
authors.initials: T
authors.lastname: Nishi
authors.forename: Osamu
authors.initials: O
authors.lastname: Chino
authors.forename: Hideo
authors.initials: H
authors.lastname: Shimada
authors.forename: Makiko
authors.initials: M
authors.lastname: Tanaka
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Inoue
authors.forename: Sadaki
authors.initials: S
authors.lastname: Inokuchi
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Makuuchi
mesh_terms: D000368:Aged; D004938:Esophageal Neoplasms / Q000473:pathology* / Q000601:surgery; D016629:Esophagectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D016019:Survival Analysis