Clinical impact of tumor-infiltrating inflammatory cells in primary small cell esophageal carcinoma

Abstract

Primary small cell esophageal carcinoma is a rare and aggressive type of gastrointestinal cancer with poor prognosis. In the present study, the impact of tumour infiltrating inflammatory cells on clinico-pathological characteristics and the patients' prognosis were analysed. A total of 36 small cell esophageal carcinomas, 19 adjacent normal tissues and 16 esophageal squamous cell carcinoma samples were collected. Qualified pathologists examined eosinophils, neutrophils, lymphocytes and macrophages on histochemical slides. The infiltration of eosinophils and macrophages in small cell esophageal carcinoma was significantly increased as compared with tumor adjacent normal tissues, and was significantly less in esophageal squamous cell carcinoma. Macrophage count was significantly associated with (p = 0.015) lymph node-stage in small cell esophageal carcinoma. When we grouped patients into two groups by counts of infiltrated inflammatory cells, Kaplan-Meier analysis revealed that high macrophage infiltration group (p = 0.004) and high eosinophil infiltration group (p = 0.027) had significantly enhanced survival. In addition, multivariate analysis unveiled that eosinophil count (p = 0.002) and chemotherapy (Yes vs. No, p = 0.001) were independent prognostic indicators. Taken together, infiltration of macrophages and eosinophils into the solid tumor appear to be important in the progression of small cell esophageal carcinoma and patients' prognosis.

Figure 1

Infiltration of macrophages and eosinophils into the SmCEC tissues and tumor adjacent normal tissues. (A) Macrophages in tumor adjacent normal tissue; (B) Macrophages in SmCEC; (C) Eosinophils in tumor adjacent normal tissue; and (D) Eosinophils in SmCEC. (Original magnification 200×) Insets: higher magnifications of macrophages and eosinophils (Original magnification 800×).

Figure 2

Kaplan-Meier survival curves of SmCEC patients (A) High macrophage counts in SmCEC correlated with better overall survival (p = 0.004); (B) High eosinophil counts in SmCEC correlated with better overall survival (p = 0.027).