BACKGROUND. Esophageal carcinoma is one of the most lethal tumors. Therefor
e, it is important to identify prognostic factors for patients with this di
sease. The objective of this study was to clarify the relation between clin
icopathologic and biologic factors in esophageal carcinoma and to determine
the prognostic significance of different biologic factors.
METHODS, DNA ploidy pattern, Ki-67 labeling index (LI), and cyclin D1 and p
53 protein expression were examined and detailed pathologic examinations we
re conducted on tumors from 53 patients (46 males and 7 females with a mean
age of 66 years [range, 47-85 years]) with surgically resected esophageal
squamous cell carcinoma and the prognostic value of these factors was evalu
ated.
RESULTS, Of the 53 esophagus carcinomas examined, 26 (49%) were classified
as DNA diploid. The mean Ki-67 LI was 45 +/- 4.9% (range, 10.5-86.1%). p53
expression was detected in 38 of the carcinomas (71.7%) and cyclin D1 expre
ssion was detected in 35 (66%). Various prognostic factors were examined us
ing the Cox stepwise regression model, four of which were found to correlat
e with overall survival: tumor size (P = 0.0346), lymph node status (P = 0.
0384), Ki-67 LI (P = 0.0161), and p53 expression (P = 0.001). Lower Ki-67 L
I and a lower rate of p53 expression were detected in the long term surviva
l group (> 3 years) compared with the short term survival group (P = 0.0004
5 and P = 0.0023, respectively).
CONCLUSIONS. The biologic factors of Ki-67 LI and p53 expression, as well a
s clinicopathologic factors, may be used as independent prognostic factors
for patients with esophageal carcinoma. However. the results of the current
study do not support cyclin D1 expression as a prognostic factor. (C) 1999
American Cancer Society.