Local Invasion Patterns Characterized by SARIFA and Tumor Budding Differ and Have
Distinct Prognostic Significance in Esophageal Adenocarcinoma and Squamous Cell Carcinoma
New National Excellence Program(ÚNKP-23-4-II-SE-24)
Egyetemi Kutatói Ösztöndíj Program(EKÖP-2024-72) Támogató: Kulturális és Innovációs
Minisztérium Nemzeti Kutatási Fejlesztési és Innovációs Alap
Szakterületek:
Onkológia
Both esophageal squamous cell carcinoma (ESQCC) and adenocarcinoma (EAC) are known
to have poor prognosis. We aimed to investigate the invasion front areas of 57 ESQCC
and 43 EAC cases to find histological signs of metastatic progression. Tumor cell
clusters with different cell counts, including tumor buds (TBs) and poorly differentiated
clusters (PDCs), were assessed. The presence of the recently described Stroma AReactive
Invasion Front Area (SARIFA) phenomenon, which defines a direct contact between tumor
cells and adipocytes, was more frequently observed in EAC than in ESQCC (p = 0.004).
In adenocarcinomas, a higher prevalence of SARIFA was observed in tumors with a higher
number of small clusters (TBs and small PDCs; p < 0.001); furthermore, both the high
number of TBs (p = 0.016) and the presence of SARIFA (p = 0.001) correlated with a
higher pT stage. SARIFA positivity in EAC (p = 0.011) and high TB in ESQCC (p = 0.0006)
were found to be independent prognostic factors for lymph node metastases. Moreover,
in ESQCC, the higher absolute number of both TBs and PDCs was associated with shorter
overall survival (p = 0.0269 and p = 0.0377, respectively). Our results suggest that
the histological subtypes of esophageal cancer behave differently, namely, that different
features of the invasion front are of prognostic significance.