Abstract
BACKGROUND: Esophageal small cell carcinoma (ESCC) is an aggressive disease with poor prognosis. This study sought to describe immunohistochemical (IHC) and clinicopathological features of patients with ESCC, and to clarify how the utilization of different marker combination affects prognostic outcome. METHODS: The paraffin-embedded ESCC samples of 73 patients were immunohistochemically analyzed of neuron specific enolase (NSE), chromogranin A (CgA), synaptophysin (Syn) and thyroid transcriptional factor-1 (TTF-1). The positivity of these factors and their correlation with clinical characteristics was described. The relation between positive expression of them and survival was also analyzed. RESULTS: Immunological reactivity of the samples was Syn 68.5%, TTF-1 49.3%, NSE 90.4%, CgA 43.8%. There were 18 patients with 4 biomarkers positive (24.7%), 24 patients with 3 biomarkers positive (32.9%), 14 patients with 2 biomarkers positive (19.2%) and 12 patients with only 1 biomarker positive (16.4%). Five cases (6.8%) were all negative. The 2- and 3-year survivals were 24.8% and 19.9%, respectively. The mOS of patients without expression of four factors was significant worse than those with at least one factor of positive expression (6.1 vs. 15.3 months, P=0.002). CONCLUSIONS: Patients with ESCC have a poor prognosis. The positive labeling of Syn, CgA, NSE and TTF-1 implicated their favourable prognostic value trend. These factors or their combination might serve as useful markers in prognostic evaluation.