Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Esophageal squamous cell carcinoma with basaloid features are genetically and prognostically similar to conventional squamous cell carcinoma

Modern Pathology (2022)Cite this article

Subjects

Abstract

We compared clinicopathologic and molecular features of esophageal squamous cell carcinoma (SCC) with basaloid features to conventional SCC using surgical resections of treatment naïve esophageal carcinomas and cases available from the TCGA database. Twenty-two cases of SCC with basaloid features were identified in the Mass General Brigham pathology archives, including 9 cases with pure basaloid morphology and 13 cases with mixed other features such as conventional well- or poorly differentiated areas or sarcomatoid areas. Thirty-eight cases of conventional SCC matched by tumor stage were used as controls. HPV infection status was tested by p16 immunohistochemistry and HPV mRNA ISH. Digital slides for 94 cases of esophageal SCC from TCGA found in the Genomic Data Commons (GDC) Data Portal were reviewed. Five cases of SCC with basaloid features were identified. Genomic profiles of SCC with basaloid features were compared to the rest of 89 SCCs without basaloid features. In addition, eight tumor sections from six patients selected from our cohort underwent in-house molecular profiling. Compared to conventional SCC, SCC with basaloid features were more frequently associated with diffuse or multifocal squamous dysplasia (p < 0.001). P16 IHC was positive in 2/13 cases, whereas HPV mRNA ISH was negative in 17/17 cases (including both p16-positive cases). SCC with basaloid features and conventional SCC from TCGA showed similar rates of TP53 mutations, CDKN2A/B deletions, and CCDN1 amplifications. TP53 variants were identified in all in-house samples that had sufficient coverage. Survival analyses between SCC with basaloid features versus conventional SCC (matched for tumor stage) did not reveal any statistically significant differences. In conclusion, esophageal SCC with basaloid features has similar survival and genomic alterations to those of conventional SCC, are more frequently associated with diffuse or multifocal dysplasia, and are not associated with HPV (high-risk strains) infection.

This is a preview of subscription content

Access options

Buy article

Get time limited or full article access on ReadCube.

$32.00

Buy

All prices are NET prices.

Fig. 1: Examples of esophageal squamous cell carcinoma (SCC) with basaloid features.
Fig. 2: Ten-year survival curves of patients diagnosed with conventional (black) and basaloid SCC (red).
Fig. 3: Digital images of five cases of SCC with basaloid features taken from TCGA.
Fig. 4: Comparative genomic landscape of basaloid and conventional SCCs from TCGA.

Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. The publicly available datasets analyzed during the current study are available here: www.portal.gdc.cancer.gov.

References

  1. SEER Cancer Statistics Review, 1975-2017. Bethesda, MD: National Cancer Institute, 2020.

  2. Tachimori, Y. et al. Comprehensive registry of esophageal cancer in Japan, 2009. Esophagus 13, 110–137 (2016).

    Article  Google Scholar 

  3. Maebayashi, T. et al. A long-surviving patient with advanced esophageal basaloid squamous cell carcinoma treated only with radiotherapy: case report and literature review. BMC Gastroenterol 17, 151 (2017).

    Article  Google Scholar 

  4. Suzuki, H. & Nagayo, T. Primary tumors of the esophagus other than squamous cell carcinoma-histologic classification and statistics in the surgical and autopsied materials in Japan. Int. Adv. Surg. Oncol. 3, 73–109 (1980).

    CAS  PubMed  Google Scholar 

  5. Morales-Puebla, J. M., Toro-Rojas, M., Segura-Saint-Gerons, R., Fanego-Fernández, J. & López-Villarejo, P. Basaloid squamous cell carcinoma: report of five cases. Med. Oral Patol. Oral Cir. Bucal 15, 451–455 (2010).

    Article  Google Scholar 

  6. Wain, S. L., Kier, R., Vollmer, R. T. & Bossen, E. H. Basaloid-squamous carcinoma of the tongue, hypopharynx, and larynx: report of 10 cases. Hum Pathol 17, 1158–1166 (1986).

    CAS  Article  Google Scholar 

  7. Sekiguchi, K. et al. Pulmonary metastasectomy for esophageal basaloid squamous cell carcinoma component at 66 months after esophagectomy. Surg. Case Rep. 6, 199 (2020).

    Article  Google Scholar 

  8. Zhang, X. H., Sun, G. Q., Zhou, X. J., Guo, H. F. & Zhang, T. H. Basaloid squamous carcinoma of esophagus: a clinicopathological, immunohistochemical and electron microscopic study of sixteen cases. World J. Gastroenterol 4, 397–403 (1998).

    Article  Google Scholar 

  9. Epstein, J. I., Sears, D. L., Tucker, R. S. & Eagan, J. W. Carcinoma of the esophagus with adenoid cystic differentiation. Cancer 53, 1131–1136 (1984).

    CAS  Article  Google Scholar 

  10. Huang, Z., Liang, Y. & Wu, X. [Basaloid squamous carcinoma of the oesophagus: a distinctive clinico-pathological entity]. Chin. J. Pathol 24, 90–92 (1995).

    CAS  Google Scholar 

  11. Abe, K. et al. Basaloid-squamous carcinoma of the esophagus. A clinicopathologic, DNA ploidy, and immunohistochemical study of seven cases. Am. J. Surg. Pathol. 20, 453–461 (1996).

    CAS  Article  Google Scholar 

  12. Board WCoTE. WHO Classification of Tumours: Digestive System Tumours. Lyon (France) 2019.

  13. Cho, K. J., Jang, J. J., Lee, S. S. & Zo, J. I. Basaloid squamous carcinoma of the oesophagus: a distinct neoplasm with multipotential differentiation. Histopathology 36, 331–340 (2000).

    CAS  Article  Google Scholar 

  14. Kumagai, Y. et al. Clinicopathologic characteristics and clinical outcomes of esophageal basaloid squamous carcinoma: experience at a single institution. Int. Surg. 98, 450–454 (2013).

    Article  Google Scholar 

  15. Chen, S. B. et al. Basaloid squamous cell carcinoma of the esophagus. J. Cancer Res. Clin. Oncol. 138, 1165–1171 (2012).

    Article  Google Scholar 

  16. Sarbia, M. et al. Basaloid squamous cell carcinoma of the esophagus: diagnosis and prognosis. Cancer 79, 1871–1878 (1997).

    CAS  Article  Google Scholar 

  17. Lin, D. C., Wang, M. R. & Koeffler, H. P. Genomic and epigenomic aberrations in esophageal squamous cell carcinoma and implications for patients. Gastroenterology 154, 374–389 (2018).

    Article  Google Scholar 

  18. Network, C. G. A. R. et al. Integrated genomic characterization of oesophageal carcinoma. Nature 541, 169–175 (2017).

    Article  Google Scholar 

  19. Isidro R. A. et al. Verrucous carcinoma of the esophagus is a genetically distinct subtype of esophageal squamous cell carcinoma. Histopathology. (2021). https://doi.org/10.1111/his.14395.

  20. Garcia, E. P. et al. Validation of OncoPanel: a targeted next-generation sequencing assay for the detection of somatic variants in cancer. Arch. Pathol Lab. Med. 141, 751–758 (2017).

    CAS  Article  Google Scholar 

  21. Bellizzi, A. M. et al. Basaloid squamous cell carcinoma of the esophagus: assessment for high-risk human papillomavirus and related molecular markers. Am. J. Surg. Pathol. 33, 1608–1614 (2009).

    Article  Google Scholar 

  22. Yamasaki, T. et al. A case of esophageal squamous cell carcinoma with neuroendocrine, basaloid, and ciliated glandular differentiation. Clin. J. Gastroenterol 14, 32–38 (2021).

    Article  Google Scholar 

  23. Lam, K. Y., Ma, L. T. & Wong, J. Measurement of extent of spread of oesophageal squamous carcinoma by serial sectioning. J. Clin. Pathol. 49, 124–129 (1996).

    CAS  Article  Google Scholar 

  24. Rahimi, S. HPV-related squamous cell carcinoma of oropharynx: a review. J. Clin. Pathol. 73, 624–629 (2020).

    CAS  Article  Google Scholar 

  25. Rajendra, S., Pavey, D., McKay, O., Merrett, N. & Gautam, S. D. Human papillomavirus infection in esophageal squamous cell carcinoma and esophageal adenocarcinoma: a concise review. Ann. NY Acad. Sci. 1482, 36–48 (2020).

    CAS  Article  Google Scholar 

  26. Mohammadpour, B., Rouhi, S., Khodabandehloo, M. & Moradi, M. Prevalence and association of human papillomavirus with esophageal squamous cell carcinoma in Iran: a systematic review and meta-analysis. Iran J. Public Health 48, 1215–1226 (2019).

    PubMed  PubMed Central  Google Scholar 

  27. Liu, Y., Zhao, L., Xue, L. & Hou, Y. Selected updates in molecular and genomic pathology of esophageal cancer. Ann. NY Acad. Sci. 1482, 225–235 (2020).

    CAS  Article  Google Scholar 

  28. Singh, T. et al. Human papillomavirus infection and p53 mutation in esophageal squamous cell carcinoma and its impact on treatment outcome. J Cancer Res. Ther. 16(Supplement), S150–S155 (2020).

    PubMed  Google Scholar 

  29. Emanuel, P., Wang, B., Wu, M. & Burstein, D. E. p63 Immunohistochemistry in the distinction of adenoid cystic carcinoma from basaloid squamous cell carcinoma. Mod Pathol 18, 645–650 (2005).

    Article  Google Scholar 

  30. Salami, A., Abbas, A. E., Petrov, R., Jhala, N. & Bakhos, C. T. Comparative analysis of clinical, treatment, and survival characteristics of basaloid and squamous cell carcinoma of the esophagus. J. Am. Coll Surg. 226, 1086–1092 (2018).

    Article  Google Scholar 

  31. Lam, K. Y., Law, S., Luk, J. M. & Wong, J. Oesophageal basaloid squamous cell carcinoma: a unique clinicopathological entity with telomerase activity as a prognostic indicator. J. Pathol. 195, 435–442 (2001).

    CAS  Article  Google Scholar 

  32. Sato-Kuwabara, Y. et al. Comparative analysis of basaloid and conventional squamous cell carcinomas of the esophagus: prognostic relevance of clinicopathological features and protein expression. Tumour Biol. 37, 6691–6699 (2016).

    CAS  Article  Google Scholar 

Download references

Acknowledgements

We thank Ms. Diana McGraw for administrative support.

Funding

The authors received no external funding for this work. This study was supported through intradepartmental funds.

Author information

Authors and Affiliations

  1. Department of Pathology, Brigham and Women’s Hospital, Boston, MA, USA

    Madeline A. Sauer, Raymond A. Isidro, Fei Dong, Deepa T. Patil, Agoston T. Agoston & Lei Zhao

  2. Harvard Medical School, Boston, MA, USA

    Madeline A. Sauer, Raymond A. Isidro, Fei Dong, Deepa T. Patil, Jon O. Wee, Agoston T. Agoston, Vikram Deshpande & Lei Zhao

  3. University of Missouri School of Medicine, Columbia, MO, USA

    Madeline A. Sauer

  4. Department of Pathology, Redwood City Medical Center, The Permanente Medical Group, Boston, MA, USA

    Jing Yang

  5. Department of Surgery, Brigham and Women’s Hospital, Boston, MA, USA

    Jon O. Wee

  6. Department of Pathology, Massachusetts General Hospital, Boston, MA, USA

    Vikram Deshpande

Authors
  1. Madeline A. Sauer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jing Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Raymond A. Isidro
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Fei Dong
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Deepa T. Patil
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jon O. Wee
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Agoston T. Agoston
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Vikram Deshpande
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Lei Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

M.A.S., J.Y., and L.Z. designed the study. M.A.S., J.Y., R.A.I., F.D., A.A., D.P., J.O.W., V.D., and L.Z. collected the data. M.A.S., J.Y., R.A.I., F.D., and L.Z. analyzed the data. M.A.S. and L.Z. drafted the manuscript M.A.S., J.Y., R.A.I., F.D., A.A., D.P., J.O.W., V.D., and L.Z. revised the manuscript.

Corresponding author

Correspondence to Lei Zhao.

Ethics declarations

Competing interests

M.A.S., J.Y., R.A.I., F.D., J.O.W., A.A., D.P., and L.Z. have no relevant financial disclosures. V.D. serves on the Scientific advisory boards of Incyte and Viela and receives research support from Advanced Cell Diagnostic and Agios.

Ethics Approval/Consent to Participate

This retrospective study was approved by the Institutional Review Board of Mass General Brigham (protocol #2018P001007). No human subjects were recruited for the study.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Sauer, M.A., Yang, J., Isidro, R.A. et al. Esophageal squamous cell carcinoma with basaloid features are genetically and prognostically similar to conventional squamous cell carcinoma. Mod Pathol (2022). https://doi.org/10.1038/s41379-022-01060-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1038/s41379-022-01060-4

Search

Advanced search

Quick links