DOI: 10.36347/sjams.2019.v07i09.043

Pages: 3129-3137

Background: Esophageal squamous cell carcinoma (ESCC), the most common subtype of esophageal cancer, has a complicated and progressive multistep process, from precancerous lesions, hyperplasia, low-grade intraepithelial neoplasia (LGIEN), to high-grade intraepithelial neoplasia (HGIEN), then to ESCC in situ, and eventually to invasive ESCC. Early detection and timely intervention are important for a good outcome. Traditional pathology is difficult to identify precancerous lesions and early ESCC, so it is necessary to search for other IHC specific molecules for early clinical diagnosis.This study aimed to determine if immunohistochemistry (IHC) for SRY-related HMG box 2 (SOX2) protein coupled with H&E staining could improve the accuracy of the early pathological diagnosis of ESCC. Methods: Esophageal tissue samples from 123 patients who underwent endoscopic submucosal dissection (ESD) and were pathologically diagnosed as early ESCC or precancerous lesions were used to determine SOX2 protein expression using EnVision, a standard two-step IHC technique. Results: IHC staining for SOX2 protein displayed distinct expression features in esophageal epithelial cells of the basal layer in different stages of premalignant lesions and early ESCC. In addition, we compared the value of the pathological diagnosis between H&E staining alone and in combination with IHC staining for SOX2 protein, and found that the detection rates increased from 15.4% to 22.7% for early ESCC, and 12.2% to 17.1% for micro-invasive ESCC. Conclusion: Our results suggest that the conventional pathological technique of H&E staining in combination with IHC assessment of SOX2 protein expression in basal layer esophageal epithelial cells could be a better diagnostic modality for the pathological diagnosis of precancerous lesions and early ESCC.