DOCSLIB.ORG

Early Adenocarcinoma Originating in Submucosal Gland of Thoracic Esophagus Presenting As Submucosal Tumor

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Early Adenocarcinoma Originating in Submucosal Gland of Thoracic Esophagus Presenting As Submucosal Tumor UCTN ± Unusual cases and technical notes E237 Early adenocarcinoma originating in submucosal gland of thoracic esophagus presenting as submucosal tumor Fig. 1 Endoscopic images of the esophageal lesion. a Initial endoscopic appearance. b Endoscopic ultrasound image. c Endoscopic appearance after mu− cosectomy. Therefore, there are still debates about endoscopic mucosal resection as a treat− ment for early esophageal cancer [4,5]. In our reported case, the adenocarcinoma arose in the submucosal gland, not in epi− thelium. The definition of this tumor as “early stage” may be somewhat contro− versial. In this case, we considered that local Fig. 2 Histopathological analysis showed a tubular adenocarcinoma arising in the submucosal treatment alone was not contraindicated, glands (H&E stain; 40). since both endoscopic image and patho− logical section showed complete resec− tion, and endoscopic ultrasonography The most common malignant neoplasm The resected specimen measured and chest CT scan gave no evidence of of the esophagus is squamous cell carci− 1 0.5 0.5 cm. Microscopically, a sub− lymph node metastasis. noma. The majority of adenocarcinomas mucosal tumor composed of distorted of the esophagus originate in the esopha− tubular glands with an infiltration Endoscopy_UCTN_Code_CCL_1AB_2AC_3AB gogastric junction, Barrett’s esophagus, or growth pattern was noted. The tumor ectopic gastric mucosa [1]. Adenocarcino− was confined to the submucosa without S.−W. Wang1, C.−S. Chang1,4, J. Wang2, ma arising in a submucosal gland of the involvement of either overlying epithe− H.−Z. Yeh1,3 This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited. esophagus beneath the squamous epithe− lium or muscularis propria. Diagnosis 1 Division of Gastroenterology, Taichung lium is rare [2]. was a tubular adenocarcinoma arising in Veterans General Hospital, Taichung, A 43−year−old woman with an esophageal the submucosal glands (l" Fig. 2). Taiwan submucosal lesion about 1 cm in size, lo− After an explanation of the risks of possi− 2 Department of Pathology, Taichung cated 24 cm from the incisors (l" Fig. 1a), ble aggressive behavior of adenocarcino− Veterans General Hospital, Taichung, underwent endoscopic ultrasonography ma of the esophagus, the patient still re− Taiwan that revealed an isoechoic lesion about fused surgery or adjuvant radiation ther− 3 School of Medicine, National Yang Ming 0.5 cm in size over the deep mucosal and apy. To date (18 months of follow−up), University, Taipei, Taiwan submucosal layers of the esophageal wall there has been no evidence of recurrence 4 Institution of Medicine, Chung Shan (l" Fig. 1b). or metastasis. Medical University, Taichung, Taiwan The patient underwent endoscopic mu− There were some concerns: increased cosal resection using the cap method depth of tumor invasion increases the (EMRC) without complications risk of lymph node metastases [3], and (l" Fig. 1c). endoscopic therapy for tumors with sub− mucosal invasion may overlook this risk. Wang S−W et al. Early adenocarcinoma originating in the submucosal gland¼ Endoscopy 2008; 40: E237±E238 E238 UCTN ± Unusual cases and technical notes References Bibliography Corresponding author 1 Christensen WN, Sternberg SS. Adenocarci− DOI 10.1055/s−2008−1077680 H.−Z. Yeh, MD noma of the upper esophagus arising in ec− Endoscopy 2008; 40: E237±E238 Division of Gastroenterology, topic gastric mucosa. Two case reports and Georg Thieme Verlag KG Stuttgart ´ New York ´ Taichung Veterans General Hospital review of the literature. Am J Surg Pathol ISSN 0013−726X No. 160, Sec. 3, Chung−Kang Road 1987; 11: 397± 402 Taichung 2 Endoh Y, Miyawaki M, Tamura G et al. Esoph− Taiwan ageal adenocarcinoma that probably origi− Fax: +886−4−23741331 nated in the esophageal gland duct: a case [email protected] report. Pathol Int 1999; 49: 156 ± 159 3 Shimada H, Nabeya Y, Matsubara H et al. Prediction of lymph node status in patients with superficial esophageal carcinoma: a− nalysis of 160 surgically resected cancers. Am J Surg 2006; 191: 250 ± 254 4 Pech O, May A, Gossner L et al. Curative en− doscopic therapy in patients with early esophageal squamous−cell carcinoma or high−grade intraepithelial neoplasia. En− doscopy 2007; 39: 30± 35 5 Rahden BH von, Stein HJ. Endoscopic muco− sal resection as curative therapy for esoph− ageal cancer is inappropriate and should be discouraged. Endoscopy 2008; 40: 169 This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited. Wang S−W et al. Early adenocarcinoma originating in the submucosal gland¼ Endoscopy 2008; 40: E237 ±E238.
Load more

Recommended publications
  • Nomina Histologica Veterinaria, First Edition
    NOMINA HISTOLOGICA VETERINARIA Submitted by the International Committee on Veterinary Histological Nomenclature (ICVHN) to the World Association of Veterinary Anatomists Published on the website of the World Association of Veterinary Anatomists www.wava-amav.org 2017 CONTENTS Introduction i Principles of term construction in N.H.V. iii Cytologia – Cytology 1 Textus epithelialis – Epithelial tissue 10 Textus connectivus – Connective tissue 13 Sanguis et Lympha – Blood and Lymph 17 Textus muscularis – Muscle tissue 19 Textus nervosus – Nerve tissue 20 Splanchnologia – Viscera 23 Systema digestorium – Digestive system 24 Systema respiratorium – Respiratory system 32 Systema urinarium – Urinary system 35 Organa genitalia masculina – Male genital system 38 Organa genitalia feminina – Female genital system 42 Systema endocrinum – Endocrine system 45 Systema cardiovasculare et lymphaticum [Angiologia] – Cardiovascular and lymphatic system 47 Systema nervosum – Nervous system 52 Receptores sensorii et Organa sensuum – Sensory receptors and Sense organs 58 Integumentum – Integument 64 INTRODUCTION The preparations leading to the publication of the present first edition of the Nomina Histologica Veterinaria has a long history spanning more than 50 years. Under the auspices of the World Association of Veterinary Anatomists (W.A.V.A.), the International Committee on Veterinary Anatomical Nomenclature (I.C.V.A.N.) appointed in Giessen, 1965, a Subcommittee on Histology and Embryology which started a working relation with the Subcommittee on Histology of the former International Anatomical Nomenclature Committee. In Mexico City, 1971, this Subcommittee presented a document entitled Nomina Histologica Veterinaria: A Working Draft as a basis for the continued work of the newly-appointed Subcommittee on Histological Nomenclature. This resulted in the editing of the Nomina Histologica Veterinaria: A Working Draft II (Toulouse, 1974), followed by preparations for publication of a Nomina Histologica Veterinaria.
    [Show full text]
  • Aandp2ch25lecture.Pdf
    Chapter 25 Lecture Outline See separate PowerPoint slides for all figures and tables pre- inserted into PowerPoint without notes. Copyright © McGraw-Hill Education. Permission required for reproduction or display. 1 Introduction • Most nutrients we eat cannot be used in existing form – Must be broken down into smaller components before body can make use of them • Digestive system—acts as a disassembly line – To break down nutrients into forms that can be used by the body – To absorb them so they can be distributed to the tissues • Gastroenterology—the study of the digestive tract and the diagnosis and treatment of its disorders 25-2 General Anatomy and Digestive Processes • Expected Learning Outcomes – List the functions and major physiological processes of the digestive system. – Distinguish between mechanical and chemical digestion. – Describe the basic chemical process underlying all chemical digestion, and name the major substrates and products of this process. 25-3 General Anatomy and Digestive Processes (Continued) – List the regions of the digestive tract and the accessory organs of the digestive system. – Identify the layers of the digestive tract and describe its relationship to the peritoneum. – Describe the general neural and chemical controls over digestive function. 25-4 Digestive Function • Digestive system—organ system that processes food, extracts nutrients, and eliminates residue • Five stages of digestion – Ingestion: selective intake of food – Digestion: mechanical and chemical breakdown of food into a form usable by
    [Show full text]
  • 組織學實驗：消化系統 I Histology Laboratory : Digestive System I
    組織學實驗：消化系統 I Histology laboratory : Digestive system I 實驗講義 : 陳世杰 老師 Shih-Chieh Chen, PhD. 張瀛双 Ying-Shuang Chang 李怡琛 Yi-Chen Lee 張昭元 Chao-Yuah Chang 劉俊馳 Chun-Chih Liu :07-3121101 ext 2144-18 :[email protected] Please study these slides before coming to the class! Sources of the Pictures & Text Wheater’s Functional Histology (4th ed) B. Young & J. W. Heath Histology: A Text and Atlas (4th ed) M.H. Ross & W. Pawlina Photomicrograph Taken by Department of anatomy, Kaohsiung Medical University Learning Objective Microscopic structure of digestive system 93W6748 Esophagus, Middle portion, human (cs) H&E 93W6746 Esophagus, Upper portion, human (cs) H&E 93W4875 Trachea and Esophagus (cs) H&E 93W4506 Esophagus and stomach (ls) H&E 93W4508 Stomach, composite (sec.) H&E 93W4522 Stomach and Duodenum (ls) H&E 93W4523 Digestive system, Composite (sec.) H&E Wheater’s Functional Histology Learning Objective • To understand the basic structural organization of the wall of alimentary tube. • Identify the esophagus, the stomach and the small intestine. • Identify the upper, middle, and lower portion of the esophagus. • Identify the duodenum, jejunum, and ileum of the small intestine. V M S ME A Fig 1. 93W6748 Esophagus, middle M: Mucosa S: Submucosa ME: Muscularis externa A: Adventitia portion, human, H&E V: Vessels Fig 1. 93W6748 Esophagus, middle portion, human, H&E. The portion of the alimentary canal that extends from the proximal part of the esophagus to the distal part of the anal canal is a hollow tube of varying diameter. This tube has the same basic structural organization throughout its length.
    [Show full text]
  • Studies on the Morphology and Life History of Nematodes in the Genus Spironoura
    THE UNIVERSITY OF ILLINOIS LIBRARY 370.5 JLL- Digitized by the Internet Archive in 2011 with funding from University of Illinois Urbana-Champaign http://www.archive.org/details/studiesonmorphol14mack ILLINOIS BIOLOGICAL MONOGRAPHS 3 Vol. XIV No - Published by the University of Illinois Under the Auspices of the Graduate School Urbana, Illinois EDITORIAL COMMITTEE John Theodore Buchholz Fred Wilbur Tanner Charles Zeleny UNIVERSITY OP ILLINOIS 1000—7-36—5800 " PI,E£S " STUDIES ON THE MORPHOLOGY AND LIFE HISTORY OF NEMATODES IN THE GENUS SPIRONOURA WITH FIVE PLATES AND TWO TEXT-FIGURES By John Gilman Mackin Contribution from the Zoological Laboratory of the University of Illinois No. 484 Distributed August 25, 1936 CONTENTS I. Introduction 7 II. Anatomy of Spironoura chelydrae (Harwood) 1932. ... 7 General External Morphology 7 Lip Supports 10 Digestive System 12 Female Reproductive System 26 Male Reproductive System 31 Musculature 33 Excretory System 36 III. Descriptions of New Species 37 Generic Diagnosis 37 Spironoura wardi n. sp 39 Spironoura concinnae n. sp 41 Key to the North American Species of Spironoura. 43 IV. Observations on Growth and Variation 44 V. Summary 48 Plates 49 Bibliographical References 62 I. INTRODUCTION Few extensive studies have been made on the anatomy and growth variations of nematodes, and these have been confined so largely to isolated and economic forms that nothing like a comprehensive knowledge of the group as a whole is available. Thus it has been deemed worth while to extend our knowledge through study of a form not too nearly related to the Ascarids, Oxyurids, and Ancylostomas, already well known.
    [Show full text]
  • The Esophageal Gland Mediates Host Immune Evasion by the Human
    The esophageal gland mediates host immune evasion FROM THE COVER by the human parasite Schistosoma mansoni Jayhun Leea, Tracy Chonga,b, and Phillip A. Newmarka,b,c,1 aRegenerative Biology, Morgridge Institute for Research, Madison, WI 53715; bHoward Hughes Medical Institute, University of Wisconsin–Madison, Madison, WI 53715; and cDepartment of Integrative Biology, University of Wisconsin–Madison, Madison, WI 53715 Edited by Robb Krumlauf, Stowers Institute for Medical Research, Kansas City, MO, and approved June 30, 2020 (received for review April 7, 2020) Schistosomes are parasitic flatworms that cause schistosomiasis, a Within the snail host, cercariae develop organs necessary for neglected tropical disease affecting over 200 million people. infection (e.g., penetration glands) and primordia of organs (e.g., Schistosomes develop multiple body plans while navigating their the digestive tract) required during the next parasitic stage complex life cycle, which involves two different hosts: a mamma- (Fig. 1B). Cercariae also contain approximately five to six stem lian definitive host and a molluscan intermediate host. Their cells that are localized stereotypically: one pair of cells on each survival and propagation depend upon proliferation and differen- side, and one cell medially (7). Previously, we showed that upon tiation of stem cells necessary for parasite homeostasis and infection of the mammalian host and transformation into schis- reproduction. Infective larvae released from snails carry a handful tosomula, these cells begin to proliferate (7), but the fates of of stem cells that serve as the likely source of new tissues as the their progeny were unexplored. In this work, we examine the parasite adapts to life inside the mammalian host; however, the contributions of these stem cells to early intramammalian de- role of these stem cells during this critical life cycle stage remains velopment.
    [Show full text]
  • The Esophageal Gland Mediates Host Immune Evasion by the Human Parasite Schistosoma Mansoni
    The esophageal gland mediates host immune evasion by the human parasite Schistosoma mansoni Jayhun Leea, Tracy Chonga,b, and Phillip A. Newmarka,b,c,1 aRegenerative Biology, Morgridge Institute for Research, Madison, WI 53715; bHoward Hughes Medical Institute, University of Wisconsin–Madison, Madison, WI 53715; and cDepartment of Integrative Biology, University of Wisconsin–Madison, Madison, WI 53715 Edited by Robb Krumlauf, Stowers Institute for Medical Research, Kansas City, MO, and approved June 30, 2020 (received for review April 7, 2020) Schistosomes are parasitic flatworms that cause schistosomiasis, a Within the snail host, cercariae develop organs necessary for neglected tropical disease affecting over 200 million people. infection (e.g., penetration glands) and primordia of organs (e.g., Schistosomes develop multiple body plans while navigating their the digestive tract) required during the next parasitic stage complex life cycle, which involves two different hosts: a mamma- (Fig. 1B). Cercariae also contain approximately five to six stem lian definitive host and a molluscan intermediate host. Their cells that are localized stereotypically: one pair of cells on each survival and propagation depend upon proliferation and differen- side, and one cell medially (7). Previously, we showed that upon tiation of stem cells necessary for parasite homeostasis and infection of the mammalian host and transformation into schis- reproduction. Infective larvae released from snails carry a handful tosomula, these cells begin to proliferate (7), but the fates of of stem cells that serve as the likely source of new tissues as the their progeny were unexplored. In this work, we examine the parasite adapts to life inside the mammalian host; however, the contributions of these stem cells to early intramammalian de- role of these stem cells during this critical life cycle stage remains velopment.
    [Show full text]
  • Bbm:978-3-642-77287-0/1.Pdf
    Appendix The figure (., data obtained from litters born in captivity; ., data from litters born in the wild. Each point on the curve is the mean for 3-9 animals.) shown below (from Cutts et at. 1978b) relates body length (snout-pump length) to age for the first 106 days of postnatal life. During the first 10 weeks, growth is linear and the increase in length is remarkably constant regardless of litter size or sex. 220 · ~ ·• 210 200 ¥ / ! 180- 110 / • J 150 I I • .1 _ 120 J J no 7 ~jlo ,/ ./ 90 V /' 7 ./ / 50 V 40 V V V I 7 10 2' 28 l5 02 49 56 63 70 77 84 91 98 '05 Age (days) 129 References Acuff ME, Krause WJ, Cutts JH (1989) The cardiac, oxyntic and pyloric glands in the developing opossum (Didelphis virginiana). Anat Anz 169:267-271 Adrian TE, Besterman HS, Mallinson CN, Greenberg GR, Bloom SR (1978) Inhibition of secretin stimulated pancreatic secretion by pancreatic polypeptide. Gut 20:37-40 Ahonen A (1973) Histochemical and electron microscopic observations on the development, neural control and function of the Paneth cells of the mouse. Acta Physiol Scand [Suppl] 398:1-71 Ahonen A, PenttiHi A (1975a) Effect of Trasylol on Paneth cells of the mouse. Experientia 31:577-578 Ahonen A, Penttilii A (1975b) Effects of glucagon and insulin on the Paneth cells of the mouse duodenum. Experientia 31:1074-1075 Alberts B, Bray D, Lewis J, Raff M, Roberts K, Watson JD (1989) Molecular biology of the cell, 2nd edn. Garland, New York AI-Nafussi AI, Wright NA (1982) Cell kinetics in the mouse small intestine during immediate postnatal life.
    [Show full text]
  • Gastrointestinal
    152A ANNUAL MEETING ABSTRACTS 627 IQGAP1 Copy Number in Follicular-Patterned Lesions of the dysplastic BE and EAC from the resection specimens were reviewed and area with Thyroid – A Pilot Study more than 80% of lesion was macrodissected from the frozen block followed by DNA AE Walts, A Riley-Portuges, S Bose. Cedars-Sinai Medical Center, Los Angeles, CA. extraction using TRIzol Reagent (Life Technologies, CA) with post-PCR purifi cation. Background: The accuracy and reproducibility of the diagnosis of follicular-patterned Microarray analysis was performed using bacterial artifi cial chromosome (BAC) DNA thyroid lesions (FPTL) is currently limited by subjective morphological criteria microarrays (Constitutional Chip 4.0, PerkinElmer, Finland). This microarray has over and diffi culties in assessing capsular integrity and vascular invasion. IQGAP1 is a 5200 BAC clones, including targeted coverage in well-characterized chromosomal widely conserved multifunctionl protein currently thought to play an important role regions, subtelomeric regions, and pericentromeric regions, as well as backbone in cell polarity, adhesion, migration and proliferation through regulation of the actin coverage of the genome with an average resolution of 0.5 Mb. DNA extracted from microtubule cytoskeleton, transmembrane traffi cking, and intracellular signaling. either BE or EAC tissue was analyzed using DNA from squamous mucosa from the IQGAP1 genetic copy gain has recently been reported in association with increased same patient as a reference. Arrays were scanned at 10 microns using a ScanArray Gx invasiveness in some thyroid tumors. This pilot study was designed to explore the scanner (PerkinElmer) and analyzed using GenePix Pro 6.1 (Molecular Devices, CA). potential role of IQGAP1 copy number (CN) in the diagnosis of FPTL.
    [Show full text]
  • Nomina Histologica Veterinaria
    NOMINA HISTOLOGICA VETERINARIA Submitted by the International Committee on Veterinary Histological Nomenclature (ICVHN) to the World Association of Veterinary Anatomists Published on the website of the World Association of Veterinary Anatomists www.wava-amav.org 2017 CONTENTS Introduction i Principles of term construction in N.H.V. iii Cytologia – Cytology 1 Textus epithelialis – Epithelial tissue 10 Textus connectivus – Connective tissue 13 Sanguis et Lympha – Blood and Lymph 17 Textus muscularis – Muscle tissue 19 Textus nervosus – Nerve tissue 20 Splanchnologia – Viscera 23 Systema digestorium – Digestive system 24 Systema respiratorium – Respiratory system 32 Systema urinarium – Urinary system 35 Organa genitalia masculina – Male genital system 38 Organa genitalia feminina – Female genital system 42 Systema endocrinum – Endocrine system 45 Systema cardiovasculare et lymphaticum [Angiologia] – Cardiovascular and lymphatic system 47 Systema nervosum – Nervous system 52 Receptores sensorii et Organa sensuum – Sensory receptors and Sense organs 58 Integumentum – Integument 64 INTRODUCTION The preparations leading to the publication of the present first edition of the Nomina Histologica Veterinaria has a long history spanning more than 50 years. Under the auspices of the World Association of Veterinary Anatomists (W.A.V.A.), the International Committee on Veterinary Anatomical Nomenclature (I.C.V.A.N.) appointed in Giessen, 1965, a Subcommittee on Histology and Embryology which started a working relation with the Subcommittee on Histology of the former International Anatomical Nomenclature Committee. In Mexico City, 1971, this Subcommittee presented a document entitled Nomina Histologica Veterinaria: A Working Draft as a basis for the continued work of the newly-appointed Subcommittee on Histological Nomenclature. This resulted in the editing of the Nomina Histologica Veterinaria: A Working Draft II (Toulouse, 1974), followed by preparations for publication of a Nomina Histologica Veterinaria.
    [Show full text]
  • Digestive System
    Chapter 25 *Lecture PowerPoint The Digestive System *See separate FlexArt PowerPoint slides for all figures and tables preinserted into PowerPoint without notes. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Introduction • Most nutrients we eat cannot be used in existing form – Must be broken down into smaller components before the body can make use of them • Digestive system—essentially a disassembly line – To break down nutrients into a form that can be used by the body – To absorb them so they can be distributed to the tissues • Gastroenterology—the study of the digestive tract and the diagnosis and treatment of its disorders 25-2 General Anatomy and Digestive Processes • Expected Learning Outcomes – List the functions and major physiological processes of the digestive system. – Distinguish between mechanical and chemical digestion. – Describe the basic chemical process underlying all chemical digestion, and name the major substrates and products of this process. 25-3 General Anatomy and Digestive Processes Cont. – List the regions of the digestive tract and the accessory organs of the digestive system. – Identify the layers of the digestive tract and describe its relationship to the peritoneum. – Describe the general neural and chemical controls over digestive function. 25-4 Digestive Function • Digestive system—the organ system that processes food, extracts nutrients from it, and eliminates the residue 25-5 Digestive Function • Five stages of digestion – Ingestion: selective intake of
    [Show full text]
  • Histology of the Blood Vessels
    + Motivational Corner: “Step through new doors. The majority of the time there's something fantastic on the other side.” Objectives: 1- By the end of this lecture, the student should be able to discuss Integrated Esophagus the microscopic structure in & stomach. correlation with the function of the following organs: 1. Esophagus. 2. Stomach. Extra notes: Gray Important notes: Red + Alimentary Canal Is the tubular portion of digestive system. Subdivided into Large intestine Small intestine (cecum, colon, Esophagus. Stomach. (duodenum, rectum, anal canal, jejunum and ileum). and appendix). Mucosa. General or Serosa Architecture Submucosa. of L/M Structure of Alimentary Muscularis externa. Canal Adventitia OR serosa. + Esophagus ■ Four concentric layers: Mucosa Submucosa Muscularis Serosa or externa Adventitia Epithelial Lining: • Loose areolar C.T. • Two muscle layers: • Adventitia: is loose Non-Keratinized containing blood 1-Inner circular layer. areolar C.T. not Stratified Squamous vessels, nerves, 2-Outer longitudinal layer. covered by Epithelium. submucosal mesothelium. esophageal glands • Upper 1/3: both layers In the thoracic part of are skeletal M. Lamina propria: (secretion of mucus) the esophagus. Loose areolar C.T. with • Middle 1/3: inner layer is smooth muscle mucosal esophageal • Meissner’s plexus glands (secretion of • Outer layer is skeletal • Serosa: is loose of nerve fibers and mucus) in the upper and M. areolar C.T. covered nerve cells. • Lower 1/3: both layers lower ends. by mesothelium are smooth M. (simple squamous • Auerbach’s Muscularis mucosae: (myenteric) plexus in epithelium) Few layers of smooth between the 2 layers in the abdominal part muscle fibers. of the esophagus. Serosa Submucosal esophageal gland Auerbach’s plexua + Stomach It has 4 regions: Mucosa has folds, • Cardia known as rugae • Fundus • Body that disappear in • Pylorus the distended stomach.
    [Show full text]
  • Risk Factors and Pathological Characteristics for Intraductal Tumor
    www.nature.com/scientificreports OPEN Risk factors and pathological characteristics for intraductal tumor spread of submucosal gland in early esophageal squamous cell neoplasia Wen-Lun Wang1,2,7, I-Wei Chang 3,4,5,7, Ming-Hung Hsu2, Tzu-Haw Chen2, Chao-Ming Tseng 2, Cheng-Hao Tseng 2, Chi-Ming Tai2, Hsiu-Po Wang6 ✉ & Ching-Tai Lee2 ✉ The esophageal gland duct may serve as a pathway for the spread of early esophageal squamous cell neoplasia (ESCN) to a deeper layer. Deep intraductal tumor spreading cannot be completely eradicated by ablation therapy. However, the risk factors of ductal involvement (DI) in patients with ESCNs have yet to be investigated. We consecutively enrolled 160 early ESCNs, which were treated with endoscopic submucosal dissection. The resected specimens were reviewed for the number, morphology, resected margin, distribution and extension level of DI, which were then correlated to clinical factors. A total of 317 DIs (median:3, range 1–40 per-lesion) in 61 lesions (38.1%) were identifed. Of these lesions, 14 have DIs maximally extended to the level of lamina propria mucosa, 17 to muscularis mucosae, and 30 to the submucosa. Multivariate logistic regression analysis showed that tumors located in the upper esophagus (OR = 2.93, 95% CI, 1.02–8.42), large tumor circumferential extension (OR = 5.39, 95% CI, 1.06–27.47), deep tumor invasion depth (OR = 4.12, 95% CI, 1.81–9.33) and numerous Lugol-voiding lesions in background esophageal mucosa (OR = 2.65, 95% CI, 1.10–6.37) were risk factors for DI. The maximally extended level of ducts involved were signifcantly correlated with the cancer invasion depth (P < 0.05).
    [Show full text]