Clinicopathological Analysis of Esophageal Carcinoma with Submucosal Invasion

Thiryteen-one cases of esophageal carcinoma invading the submucosal were analyzed regarding the degree of submucosal invasion, the growth patterns, the mode of invasion, and the expression of matrix metalloproteinase-2 (MMP-2). For the degree of submucosal invasion, the deeply invading type (sm3: 10 cases) was characterized by a tendency toward the superficial and protruding type (type 0-I), a high incidence of lymph node metastasis, vascular invasion, and post-operative recurrence. In contrast, the slightly invading type (sm1: 6 cases) was characterized by the slightly elevated type (type O-IIa), a low incidence of lymph node metastasis, vascular invasion, and recurrence. For the growth patterns, the majority of down growth type (13 cases) was in type O-I, and this type was associated with lymph node metastasis, while, almost all of the superficial spreading type (8 cases) was in type O-IIa, which was associated with blood vessel invasion and recurrence. On the other hand, in the mode of invasion, the group with diffuse invasion (G3, G4C, and G4D) had lymph node metastasis more frequently than the group with non-diffuse invasion (G1 and G2). In immunohistochemical staining, the expression of MMP-2 was detected in 9 (29%) cases. Its expression, however, was not detected in non-cancerous esophageal epithelia. A good correlation was found among the expression of MMP-2, lymphatic invasion, and post-operative recurrence.