Clinicopathological significance of tumor nest configuration in patients with esophageal squamous coil carcinoma

BACKGROUND, Cancer-stromal interactions are an important mediator of cancer invasion and metastasis. METHODS, The authors investigated the clinicopathological significance of t umor nest configuration and the surrounding stroma in 159 patients with adv anced esophageal squamous cell carcinoma (ESCC). The tumors were classified microscopically into two types. Type A tumors had oval-shaped or sheet-lik e tumor nests (with >80% of the tumor area showing these features). Type B tumors had asteroid-shaped or scattered small tumor nests (with > 20% of th e tumor area showing these features). RESULTS, Of the 159 tumors examined, 38 (24%) were type A and 121 (76%) wer e type B. Type B tumors had a significantly deeper invasion depth, more fre quent lymphatic permeation and lymph node metastasis, more prominent active fibroblastic stroma, and less frequent inflammatory cell infiltration (P<0 .05). Both univariate (P < 0.05) and multivariate (P < 0.05) analysis of th e patients' survival showed that the prognosis for patients with type B tum ors was significantly worse than for patients with type A tumors. CONCLUSIONS. This study showed that tumor nest configuration which correspo nded to the behavior of tumor cells against stromal cells, correlated well with the aggressiveness of the tumor. Cancer 2001;91:2114-20. (C) 2001 Amer ican Cancer Society.