Endhardt K, Märkl B, Probst A, Schaller T, Aust D. Value of histomorphometric tumour thickness and smoothelin for conventional m-classification in early oesophageal adenocarcinoma.
World J Gastrointest Oncol 2017;
9:444-451. [PMID:
29204253 PMCID:
PMC5700386 DOI:
10.4251/wjgo.v9.i11.444]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 08/17/2017] [Accepted: 09/05/2017] [Indexed: 02/05/2023] Open
Abstract
AIM
To test the validity of tumour thickness measurement in distinguishing between the different infiltration depths, especially when the duplication of muscularis mucosae cannot be demarcated clearly.
METHODS
We re-evaluated 100 completely embedded Barrett’s adenocarcinomas regarding m-classification, maximum tumour thickness, and muscularis mucosae duplication. For validation, smoothelin staining was performed on a subset of cases.
RESULTS
The m1-, m2- and m3-classified adenocarcinomas showed a significant lower tumour thickness compared to the m4- and sm1-classified lesions (P < 0.001). Smoothelin staining determined a clear muscularis mucosae duplication in 64% of the tested samples and enabled the differentiation of the two layers in diffuse and merged splits.
CONCLUSION
Tumour thickness in early oesophageal adenocarcinoma significantly correlates with the depth of infiltration and demonstrates its worth as an accurate pT classification in non-polypoid lesions. We created a new algorithm, which combines histomorphology with morphometric analyses. It is noteworthy that it facilitates the assessment of mucosal vs submucosal infiltration depth. The smoothelin staining strengthened our results of the tumour thickness evaluation and can be used in cases of doubt.
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