ISSN:
0897-3806
Keywords:
scanning electron microscopy
;
dysplasia
;
microplicae
;
resection margins
;
Life and Medical Sciences
;
Miscellaneous Medical
Source:
Wiley InterScience Backfile Collection 1832-2000
Topics:
Medicine
Notes:
The diagnosis of esophageal carcinoma carries an extremely poor prognosis. Even after apparently curative resection, with histologically normal resection margins, there is a high incidence of locally recurrent disease. This study was performed to determine if cell surface morphological abnormalities, indicative of a “field change,” are present in the esophageal mucosa of patients with squamous carcinoma of the esophagus. Seven patients with squamous cell carcinoma of the esophagus and seven patients with a normal esophagus were studied. Biopsies were examined using both light and scanning electron microscopy; they were taken from the midesophagus in the normal group and from the tumor, the normal mucosa adjacent to the tumor, and the proximal surgical resection margin in the tumor group. There was a characteristic pattern of abnormalities present in both the mucosa adjacent to tumor and the resection margin, indicative of a field change. The microplicae on the cell surfaces were reduced in number and were unfolded, and defects were found in the extracellular matrix giving rise to intercellular fissures. These changes reflect increased cell turnover and increased cell exfoliation. We conclude that scanning electron microscopy can detect widespread changes in the esophageal mucosa of patients with esophageal cancer that are not detectable by light microscopy. The fact that such field changes exist as far as the proximal surgical resection margin may help explain locally recurrent disease after apparently curative surgery.
Additional Material:
12 Ill.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1002/ca.980030203
Permalink
