Clinico-pathologic Study on Multiple Squamous Epithelial Neoplasia of the Esophagus

Cho, Kyung Ja; Lee, Seung Sook; Koh, Jae Soo; Zo, Jae Ill; Jang, Ja June

Abstract

PURPOSE: Multicentric occurrence of esophageal squamous neoplasm has been known to be significant in terms of its pathogenesis and production of detectable early lesions. This study was performed to establish the incidence, pattem and clinico-pathologic features of multiple squamous epithelial neoplasia of the esophagus in Korea.
MATERIALS AND METHODS
Forty-two consecutive cases of esophageal squamous cell carcinoma surgically treated at Korea Cancer Center Hospital in 1991 were studied. For pathological analysis, whole esophagectomy specimens were sectioned, micrascopically examined, and reconstructed. Age, sex, alcohol and smoking history, tumor location, stage, lymph node metastasis and survival were compared among different neoplastic conditions. RESULT: Fifteen cases (35.7%) showed multiple squamous lesions, 6 (14.3%) with multiple carcinomas and dysplasias, and 9 (21.4%) with single carcinomas with separate dysplasias. Intraepithelial lesions contiguous to main tumors were commonly observed (61.9%). Lugol`s solution staining pattern was compatible with epithelial pathology. Lymph node metastasis rate was significantly higher in cases with multiple carcinomas. Smoking history was significantly more common in patients with solitary catcinomas only.
CONCLUSION
The multicentric occurrence of squamous epithelial dysplasia and carcinoma in the esophagus was confirmed in Korean patients, supporting the concept of field carcinogenesis at this region. However, lack of evidence for strong environmental influence in the patients with multiple lesions suggests yet another risk factor.