Paneth cell differentiation associated with neoadjuvant therapy in esophageal adenocarcinoma.

IF 2.3 4区 医学 Q2 PATHOLOGY American journal of clinical pathology Pub Date : 2024-08-07 DOI:10.1093/ajcp/aqae098
Madhurya Ramineni, Sarah K Findeis, Jiqing Ye, Yansheng Hao
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Abstract

Objectives: Paneth cells and Paneth cell metaplasia are well-known in pathology as foundational components in the gastrointestinal system. When within malignant cells (Paneth cell differentiation [PCD]), however, the function and significance of these cells is less well understood. Here, we present findings from the first study focused on PCD in postneoadjuvant esophageal adenocarcinoma (EAC) resection specimens.

Methods: Patients with EAC treated with neoadjuvant chemoradioation and followed by esophagectomy between 2012 and 2018 in our institution were retrospectively evaluated. A tissue microarray was constructed, and special and immunohistochemical stains were performed.

Results: A total of 64 cases were collected, of which 8 had PCD, as highlighted by periodic acid-Schiff with diastase staining. Adenocarcinomas with PCD were more commonly seen in patients 60 to 70 years of age and typically had a poorly differentiated morphology, observationally fewer stromal mucinous changes, and less lymph node metastasis. β-catenin activation induced by neoadjuvant therapy was more frequent in the PCD-positive cases. Patients with PCD-positive disease had low programmed cell death 1 ligand 1 levels, no positive or equivocal ERBB2 (HER2) expression, and low CD8-positive T-cell infiltration; they were also mismatch repair proficient. Patients with PCD-positive disease showed a survival pattern inferior to that of patients with PCD-negative disease.

Conclusions: When induced by neoadjuvant therapy in EAC, PCD is associated with high β-catenin activation, less expression of targetable biomarkers, and a potentially worse clinical prognosis.

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与食管腺癌新辅助治疗相关的潘氏细胞分化
目的:众所周知,病理学中的Paneth细胞和Paneth细胞变性是胃肠道系统的基础成分。然而,当这些细胞进入恶性细胞(Paneth 细胞分化 [PCD])时,其功能和意义就不那么为人所知了。在此,我们将介绍第一项关于新辅助治疗后食管腺癌(EAC)切除标本中的 PCD 的研究结果:我们对本机构2012年至2018年期间接受新辅助化疗并随后进行食管切除术的EAC患者进行了回顾性评估。构建了组织芯片,并进行了特殊染色和免疫组化染色:结果:共收集到64例病例,其中8例有PCD,通过周期性酸-Schiff加二淀粉酶染色显示。伴有PCD的腺癌多见于60至70岁的患者,通常形态分化较差,基质粘液性改变较少,淋巴结转移也较少。在 PCD 阳性病例中,新辅助治疗诱导的β-catenin 激活更为常见。PCD阳性患者的程序性细胞死亡1配体1水平较低,ERBB2(HER2)无阳性表达或表达不明确,CD8阳性T细胞浸润较低;他们还具有错配修复能力。PCD阳性患者的生存模式不如PCD阴性患者:结论:当新辅助治疗诱发EAC时,PCD与β-catenin高度活化、可靶向的生物标记物表达较少以及潜在的较差临床预后有关。
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来源期刊
CiteScore
7.70
自引率
2.90%
发文量
367
审稿时长
3-6 weeks
期刊介绍: The American Journal of Clinical Pathology (AJCP) is the official journal of the American Society for Clinical Pathology and the Academy of Clinical Laboratory Physicians and Scientists. It is a leading international journal for publication of articles concerning novel anatomic pathology and laboratory medicine observations on human disease. AJCP emphasizes articles that focus on the application of evolving technologies for the diagnosis and characterization of diseases and conditions, as well as those that have a direct link toward improving patient care.
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