Skip to main content

Advertisement

Log in

Early Barrett's carcinoma: the depth of infiltration of the tumour correlates with the degree of differentiation, the incidence of lymphatic vessel and venous invasion

  • Original Article
  • Published:
Virchows Archiv Aims and scope Submit manuscript

Abstract

The incidence of regional lymph node metastasis in early Barrett's carcinoma is determined by the depth of infiltration of the tumour. The present study investigated the possible relationship between the depth of infiltration of the tumour, its degree of differentiation and the incidence of lymphatic vessel and venous invasion in early Barrett's carcinoma. To this end, a total of 805 endoscopically resected specimens obtained from 472 patients with early Barrett's carcinomas were analysed. The results of this analysis revealed that increasing depth of tumour infiltration is associated with an increase in the incidence of poorly differentiated carcinomas—from 0.8% for lesions limited to the mucosa (m1) to 41.4% when the depth of infiltration extended to the lower third of the submucosa (sm3). A similar correlation was also found for the incidence of lymphatic vessel invasion (m1, 0.6%; sm3, 44.8%) and for venous invasion (m1, 0%; sm3, 13.8%). All of these observations proved to be statistically highly significant (p < 0.001). In conclusion, the results show that the degree of differentiation, as well as the incidence of lymphatic vessel and venous invasion, correlates with the depth of infiltration of the early carcinoma in Barrett's oesophagus.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Paraf F, Flejou JF, Pignon JP et al (1995) Surgical pathology of adenocarcinoma arising in Barrett's esophagus. Analysis of 67 cases. Am J Surg Pathol 19:183–191

    Article  CAS  PubMed  Google Scholar 

  2. Rice TW, Zuccaro G Jr, Adelstein DJ et al (1998) Esophageal carcinoma: depth of tumor invasion is predictive of regional lymph node status. Ann Thorac Surg 65:787–792

    Article  CAS  PubMed  Google Scholar 

  3. Ruol A, Merigliano S, Baldan N et al (1997) Prevalence, management and outcome of early adenocarcinoma (pT1) of the esophago-gastric junction. Comparison between early cancer in Barrett's esophagus (type I) and early cancer of the cardia (type II). Dis Esophagus 10:190–195

    CAS  PubMed  Google Scholar 

  4. Stein HJ, Feith M, Mueller J et al (2000) Limited resection for early adenocarcinoma in Barrett's esophagus. Ann Surg 232:733–742

    Article  CAS  PubMed  Google Scholar 

  5. van Sandick JW, van Lanschot JJ, ten Kate FJ et al (2000) Pathology of early invasive adenocarcinoma of the esophagus or esophagogastric junction: implications for therapeutic decision making. Cancer 88:2429–2437

    Article  PubMed  Google Scholar 

  6. Buskens CJ, Westerterp M, Lagarde SM et al (2004) Prediction of appropriateness of local endoscopic treatment for high-grade dysplasia and early adenocarcinoma by EUS and histopathologic features. Gastrointest Endosc 60:703–710

    Article  PubMed  Google Scholar 

  7. Westerterp M, Koppert LB, Buskens CJ et al (2005) Outcome of surgical treatment for early adenocarcinoma of the esophagus or gastro-esophageal junction. Virchows Arch 446:497–504

    Article  PubMed  Google Scholar 

  8. Liu L, Hofstetter WL, Rashid A et al (2005) Significance of the depth of tumor invasion and lymph node metastasis in superficially invasive (T1) esophageal adenocarcinoma. Am J Surg Pathol 29:1079–1085

    PubMed  Google Scholar 

  9. Vieth M, Ell C, Gossner L et al (2004) Histological analysis of endoscopic resection specimens from 326 patients with Barrett's esophagus and early neoplasia. Endoscopy 36:776–781

    Article  CAS  PubMed  Google Scholar 

  10. Werner M, Fléjou J, Hainaut P et al (2000) Adenocarcinoma of the oesophagus. In: Hamilton SR, Aaltonen LA (eds) World Health Organization classification of tumours: pathology and genetics of tumours of the digestive system. IARC Press, Lyon, pp 20–26

    Google Scholar 

  11. Wittekind C, Meyer J, Bootz F, International Union Against Cancer (UICC) (2002) TNM Klassifikation maligner Tumoren, 6. Auflage. Springer-Verlag, Berlin, pp 55–58

    Google Scholar 

  12. Japanese Society for Esophageal Diseases (2001) Guidelines for clinical and pathologic studies on carcinoma in the esophagus, 9th edn. Kanehara & Co., Ltd., Tokyo

    Google Scholar 

  13. Bortz J, Lienert G, Boehnke K (1990) Verteilungsfreie Methoden in der Biostatistik. Springer-Verlag, Berlin, pp 121–158

    Google Scholar 

  14. Bortz J, Lienert G (1998) Kurzgefaßte Statistik für die klinische Forschung: Ein praktischer Leitfaden für die Analyse kleiner Stichproben. Springer-Verlag, Berlin, pp 71–103, 122–139

  15. Lehnert U (2000) Datenanalysesystem SPSS Version 9: handlungsorientiertes und leicht verständliches Lehrbuch zur Einführung in die statistische Datenanalyse, 3. Auflage. Oldenbourg Wissenschaftsverlag GmbH, München

    Google Scholar 

  16. Noguchi H, Naomoto Y, Kondo H et al (2000) Evaluation of endoscopic mucosal resection for superficial esophageal carcinoma. Surg Laparosc Endosc Percutan Tech 10:343–350

    CAS  PubMed  Google Scholar 

  17. May A, Gunter E, Roth F et al (2004) Accuracy of staging in early oesophageal cancer using high resolution endoscopy and high resolution endosonography: a comparative, prospective, and blinded trial. Gut 53:634–640

    Article  CAS  PubMed  Google Scholar 

  18. Murata Y, Suzuki S, Ohta M et al (1996) Small ultrasonic probes for determination of the depth of superficial esophageal cancer. Gastrointest Endosc 44:23–28

    Article  CAS  PubMed  Google Scholar 

  19. Simizu Y, Tsukagoshi H, Nakazato T et al (1995) Clinical evaluation of endoscopic ultrasonography (EUS) in the diagnosis of superficial esophageal carcinoma. Rinsho Byori 43:221–226

    CAS  PubMed  Google Scholar 

  20. Potet F, Flejou JF, Gervaz H et al (1991) Adenocarcinoma of the lower esophagus and the esophagogastric junction. Semin Diagn Pathol 8:126–136

    CAS  PubMed  Google Scholar 

  21. Vieth M, Stolte M (2005) Pathology of early upper GI cancers. Best Pract Res Clin Gastroenterol 19:857–869

    Article  PubMed  Google Scholar 

Download references

Acknowledgement

The authors are most grateful to Dr. Reinhard Wittenberg, from the Department of Sociology and Empirical Social Research, Nuremberg, Germany, for his valuable advice on statistical analysis.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Manfred Stolte.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zemler, B., May, A., Ell, C. et al. Early Barrett's carcinoma: the depth of infiltration of the tumour correlates with the degree of differentiation, the incidence of lymphatic vessel and venous invasion. Virchows Arch 456, 609–614 (2010). https://doi.org/10.1007/s00428-010-0925-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00428-010-0925-5

Keywords

Navigation