Biological evaluation of undifferentiated carcinoma of the esophagus

Background: Patients with undifferentiated carcinoma of the esophagus (UEC) are rare and have a poor prognosis compared with those with differentiated squamous cell carcinomas (DECs). We compared clinicopathological and biolo gical Features of UEC and DEC, with emphasis on markers for epithelial cell origin. proliferation, and cell-cell adhesion. Methods: Seven patients with UEC were compared with 21 with DEC. Immunohiso chemical studies were performed by using monoclonal antibodies to cytokerat in, epithelial membrane antigen, p53, p21(WAF1/C1P1), Ki-67, E-cadherin, de smoglein-1. and thrombomodulin. Results: Patients with UEC had a poorer prognosis because of hematogenous m etastasis at the time of presentation (mean survival, 6.5 +/- 6.2 vs. 35.5 +/- 28.9 months: P < .05), Immunohistochemical findings for cytokeratin and epithelial membrane antigen suggest that some UECs had epithelial origins. The following immunohistochemical profile of UEC was consistent with its h ighly malignant properties: (1) reduced or negative expression of cell-cell adhesion molecules such as E-cadherin, desmoglein-1, and thrombomodulin, ( 2) high positive rate for p53 and Ki-67, and (3) negative expression of p21 (WAF1/CIP1). Conclusions: The immunohistochemical findings for UEC showed its high cell- proliferative activity and a high potential for metastasis. Clinical featur es of UEC were supported by the results of immunohistochemical Endings.