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10.1245/s10434-006-9286-3
Annals of Surgical Oncology 14:1431-1438 (2007)
© 2007 Society of Surgical Oncology
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Original Article

Assessment of Clinical Outcome in Patients With Esophageal Squamous Cell Carcinoma Using TNM Classification Score and Molecular Biological Classification

Shinsuke Takeno, MD, PhD, Tsuyoshi Noguchi, MD, PhD, Yoshiaki Takahashi, MD, PhD, Shoichi Fumoto, MD, Tomotaka Shibata, MD and Katsunobu Kawahara, MD, PhD

Department of Oncological Science (Surgery II), Faculty of Medicine, Oita University, Idaigaoka 1-1, Hasama-machi, Yufu-City, Oita 879-5593, Japan

Correspondence: Address correspondence and reprint requests to: Shinsuke Takeno, MD, PhD; E-mail: takeno{at}med.oita-u.ac.jp

Background: The aim of this study was to assess the clinical outcome in patients with esophageal squamous cell carcinoma (ESCC) by using molecular biological classification based on immunohistochemical analysis in addition to tumor, node, metastasis system (TNM) classification.

Methods: Samples from 71 patients with ESCC who underwent surgery were analyzed immunohistochemically. Cyclin B1, E-cadherin, Bag-1, and heat-shock protein 70 were selected as the molecular biological parameters. The utility of molecular biological classification on clinical impact was examined and compared with TNM classification.

Results: Three patients were diagnosed as stage 0, 14 as stage I, 20 as stage II, 19 as stage III, and 15 as stage IV by TNM classification. Thirteen patients were classified as stage 0, 17 as stage I, 21 as stage II, 18 as stage III, and 2 as stage IV by molecular biological classification. Molecular biological stage (P < .0001) and TNM stage (P < .0001) were statistically significant prognostic parameters in univariate analysis. Twenty (28.2%) of 71 patients were assigned to the same stage by both classifications, and a significant correlation was identified between the two classifications (P = .0002). Molecular biological classification (P < .01) and TNM classification (P < .0001) were independent prognostic parameters in multivariate analysis. Combined TNM and molecular biological classification accurately reflected clinical outcome (P < .0001).

Conclusions: Molecular biological classification combined with TNM classification is useful for assessing the prognosis of patients with ESCC.

Key Words: Clinical outcome • ESCC • TNM classification • Molecular biological classification • Cyclin B1 • HSP70 • E-cadherin • BAG-1






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