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Background and aim: CD133 expression in cancer cells has been recognised as a putative cancer stem cell (CSC) marker in epithelial malignancies. CD133 expression was evaluated in gastric cancer and the clinical impact of CD133-positive... more
Background and aim: CD133 expression in cancer cells has been recognised as a putative cancer stem cell (CSC) marker in epithelial malignancies. CD133 expression was evaluated in gastric cancer and the clinical impact of CD133-positive gastric cancer was clarified. Patients and methods: Ninety-seven gastric cancer patients who received curative gastrectomy were enrolled. CD133 expression in cancerous tissue was evaluated by immunohistochemistry. Results: CD133 expression positively correlated with tumour extension and the degree of nodal involvement. CD133 expression significantly affected patient postoperative outcome. Multivariate analysis revealed CD133 positivity as an independent prognostic factor superior to the depth of invasion and similar to nodal involvement in gastric cancer (p<0.05). Conclusion: Even slight CD133 expression in gastric cancer patients may be a useful prognostic marker via CSC. Further examination of CD133 with respect to CSC markers can enable prediction of the recurrence risk of gastric cancer.
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This review summarizes and evaluates the literature regarding the biomarkers for predicting the response and/or prognosis of esophageal squamous cell carcinoma (ESCC) patients treated with neoadjuvant chemoradiation therapy (CRT). There... more
This review summarizes and evaluates the literature regarding the biomarkers for predicting the response and/or prognosis of esophageal squamous cell carcinoma (ESCC) patients treated with neoadjuvant chemoradiation therapy (CRT). There are seven categories of molecules known to correlate with the response and/or prognosis: tumor suppressors (p53, p21), cell cycle regulators (Cyclin D1, CDC25B, 14-3-3sigma), DNA repair molecules (p53R2, ERCC1), drug resistance proteins [metallothionein (MT)], angiogenic factors (VEGF), molecules involved in cell proliferation/invasion/metastasis (Ki-67, COX-2) and hedgehog signaling molecules (Gli-1). Of the above molecules, the tumor suppressor p53 is expected to be a representative biomarker for predicting the response and prognosis. The cell cycle markers CDC25B and 14-3-3sigma have potential as response biomarkers independent of the p53 status. The DNA repair markers, p53R2 or ERCC1, angiogenic molecule (VEGF), and hedgehog signaling pathway factor Gli-1 also have potential to predict the response and prognosis of ESCC. However, there are still many unanswered questions with regard to predicting the clinical effects of neoadjuvant CRT.
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Prognostic factors in esophageal squamous cell carcinoma patients treated with neoadjuvant chemoradiation therapy Hiroshi OkumuraYasuto UchikadoMasataka MatsumotoTetsuhiro OwakiYoshiaki Kita • Itaru OmotoKen SasakiToshihide SakuraiTetsuro SetoyamaBunpei Nabeki • Daisuke MatsushitaSumiya IshigamiY...more
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A 65-year-old woman was admitted with upper abdominal pain and pyrexia. She was given a diagnosis of acute pancreatitis and treated with intravenous infusion. After recovering, abdominal enhanced-CT showed a low density area in the head... more
A 65-year-old woman was admitted with upper abdominal pain and pyrexia. She was given a diagnosis of acute pancreatitis and treated with intravenous infusion. After recovering, abdominal enhanced-CT showed a low density area in the head of the pancreas, measuring 2 cm in maximum dimension. Endoscopic ultrasound guided fine-needle aspiration (EUS-FNA) revealed acinar cell carcinoma (ACC). She underwent curative subtotal stomach-preserving pancreaticoduodenectomy. The definitive diagnosis, based on the histopathological examinations including immunohistochemical staining, was ACC. ACC of the pancreas is extremely rare, occurring in approximately 1% of all cases of pancreatic neoplasm. We report a rare case diagnosed as ACC by EUS-FNA prior to surgical treatment.
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Related Article from microRNA-10b: A New Marker or the Marker of Pancreatic Ductal Adenocarcinoma?
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Research Interests: Oncology, Medicine, Multivariate Analysis, Humans, Internal Medicine, and 15 moreFemale, Male, Squamous Cell Carcinoma, Esophageal Cancer, Aged, Middle Aged, Neoplasm Invasiveness, Adult, Regression Model, Prognosis, Disease Progression, Receptor for Advanced Glycation End Products, Lymph nodes, Neoplasm staging, and multivariate analyses
In vivo orthotopic lung cancer model for the role of miR-155 in chemoresistance. (A) Injection and treatment schedule for CDDP (green arrows) and anti-miR negative control (NC) or anti-miR-155 liposomal nanoparticles (red stars) for four... more
In vivo orthotopic lung cancer model for the role of miR-155 in chemoresistance. (A) Injection and treatment schedule for CDDP (green arrows) and anti-miR negative control (NC) or anti-miR-155 liposomal nanoparticles (red stars) for four different treatment groups: mice that were injected with A549-LVEV cells and untreated (group 1), injected with A549-LVEV cells and treated with anti-miR-NC and CDDP (group 2), injected with A549-155LV cells and treated with anti-miR-NC and CDDP (group 3), and injected with A549-155LV cells and treated with anti-miR-155 and CDDP (group 4). (B) Representative pictures of dissected mice belonging to each of the treatment groups described in panel A of this Figure. Tumor nodules are marked by dotted white circles. (C-D) Graphs of the primary tumor size (C) and aggregate mass of nodules in mediastinum (D) of the four treatment groups mentioned above. (E) In situ hybridization for miR-155 for each of the four treatment groups mentioned above. (F) Immunohistochemical analysis for Ki-67 (proliferation) and CD31 (angiogenesis), as well as the TUNEL assay (apoptosis) and TP53 immunostaining for each of the four treatment groups mentioned above.
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Dose-response curves for MEC1 and MEC2 cells treated with fludarabine.
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Clinical correlation of miR-155 and TP53 expression with survival in the lung adenocarcinoma - TCGA dataset when distinguishing between TP53 wild-type and TP53 mutated samples. (A-B) Kaplan-Meier survival analysis for patients expressing... more
Clinical correlation of miR-155 and TP53 expression with survival in the lung adenocarcinoma - TCGA dataset when distinguishing between TP53 wild-type and TP53 mutated samples. (A-B) Kaplan-Meier survival analysis for patients expressing high levels of miR-155 vs. low levels of miR-155 in samples that express wild-typeTP53 or harbor TP53 mutations that do not affect TP53 function (A), and in samples expressing mutated TP53 that affects TP53 function (B). (C-D) Kaplan-Meier survival analysis for patients expressing high levels of miR-155 and low levels of TP53 vs. low levels of miR-155 and high levels of TP53 in samples that express wild-type TP53 or harbor TP53 mutations that do not affect TP53 function (C), and in samples expressing mutated TP53 that affects TP53 function (D).
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Clinical correlation of miR-155 expression with survival in leukemia. Kaplan-Meier survival analysis for patients expressing high levels of miR-155 vs. low levels of miR-155 in two CLL cohorts, CLL - NEJM (A) and CLL - Italy (B), and in... more
Clinical correlation of miR-155 expression with survival in leukemia. Kaplan-Meier survival analysis for patients expressing high levels of miR-155 vs. low levels of miR-155 in two CLL cohorts, CLL - NEJM (A) and CLL - Italy (B), and in one ALL cohort, ALL - MDACC (C).
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Supplementary Table S1 Clinical characteristics of two chronic lymphocytic leukemia patient datasets; Supplementary Table S2 Clinical characteristics of two lung cancer patient datasets; Supplementary Table S3 Clinical characteristics of... more
Supplementary Table S1 Clinical characteristics of two chronic lymphocytic leukemia patient datasets; Supplementary Table S2 Clinical characteristics of two lung cancer patient datasets; Supplementary Table S3 Clinical characteristics of the ALL dataset; Supplementary Table S4 Integrated function and pathway analysis on 248 experimentally validated targets of miR-155; Supplementary Table S5 Univariate and multivariate analyses of survival with patient characteristics and miR-155 and TP53 expression as categorical and continuous variables in different patient cohorts; Supplementary Table S6 Estimate of Cox model and multivariate Cox model, as well as the HR estimated based on the model for miR-155 high and TP53 low vs. miR-155 low and TP53 high.
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microRNA-10b (miR-10b) expression in pancreatic ductal adenocarcinoma (PDAC), as identified by in situ hybridization, is highly correlated with cancer diagnosis, therapy response, and prognosis. If these findings are further confirmed in... more
microRNA-10b (miR-10b) expression in pancreatic ductal adenocarcinoma (PDAC), as identified by in situ hybridization, is highly correlated with cancer diagnosis, therapy response, and prognosis. If these findings are further confirmed in prospective studies, miR-10b could be used to improve the management of PDAC and decrease the mortality rate of this deadly cancer. Clin Cancer Res; 17(17); 5527–9. ©2011 AACR.
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Abstracts from Proceedings of Eighth International Hematologic Malignancies 2012 Conferences from Proceedings of Eighth International Hematologic Malignancies 2012 Conference Clinical Lymphoma, Myeloma & Leukemia, Vol. 13, No. S2,... more
Abstracts from Proceedings of Eighth International Hematologic Malignancies 2012 Conferences from Proceedings of Eighth International Hematologic Malignancies 2012 Conference Clinical Lymphoma, Myeloma & Leukemia, Vol. 13, No. S2, S363-86, 2013 Chronic Lymphocytic Leukemia
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A 46-year-old female was admitted to Kagoshima University Hospital with a complaint of epigastralgia and dysphasia. Gastrointestinal scopy revealed advanced gastric cancer in the upper third of the stomach. Pathological diagnosis of the... more
A 46-year-old female was admitted to Kagoshima University Hospital with a complaint of epigastralgia and dysphasia. Gastrointestinal scopy revealed advanced gastric cancer in the upper third of the stomach. Pathological diagnosis of the biopsy specimen was moderately-differentiated adenocarcinoma. Abdominal CT suggested multiple liver metastases, so a combination of biweekly paclitaxel(PTX)and S-1 was started. After five courses of this regimen, the liver metastases and primary tumor were remarkably regressed. PTX was discontinued because of a grade 3 adverse effect of numbness. Nevertheless S-1 monotherapy for liver metastases resulted in a complete response. She has been well without tumor re-growth for 4 years. The combination of PTX and S-1 may be an effective regimen for gastric cancer with liver metastases.
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Research Interests: Surgery, Chemotherapy, Radiation Therapy, Treatment Outcome, Medicine, and 15 moreHumans, Female, Male, Squamous Cell Carcinoma, Esophageal Cancer, Aged, Middle Aged, Oral Squamous Cell Carcinoma (OSCC), Adult, Time Factors, Survival Rate, Retrospective Studies, Lymph Node, Antineoplastic Agents, and esophagectomy
Adenosquamous carcinoma of the esophagus is an uncommon type of esophageal tumor. In the present case, a 54-year-old man without symptoms was diagnosed with esophageal squamous cell carcinoma, based on endoscopic examination of a biopsy... more
Adenosquamous carcinoma of the esophagus is an uncommon type of esophageal tumor. In the present case, a 54-year-old man without symptoms was diagnosed with esophageal squamous cell carcinoma, based on endoscopic examination of a biopsy specimen. Endoscopy and barium roentgenography revealed a superficial plateau-type lesion, 2 cm in length, in the lower esophagus. Esophagectomy with lymphadenectomy was performed via a right thoraco-abdominal approach. The histological diagnosis was adenosquamous carcinoma with no lymph node metastasis. Three years after the surgery, multiple liver metastases were detected by computed tomography. The patient was treated with a combination of low-dose 5-fluorouracil(350 mg/body/day) and low-dose cisplatin (7 mg/body/day). Because the first course of chemotherapy was very effective and the number of liver metastases was reduced,a further 6 courses were administered. After 6 courses of chemotherapy, no liver metastases were detected. Based on the present findings, we recommend low-dose 5-fluorouracil/cisplatin therapy for liver metastasis from esophageal adenosquamous carcinoma.
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Background/aims: Five patients having early gastric cancer were treated using laparoscopic partial gastrectomy combined with sentinel lymph node biopsy. Methodology: Preoperatively, 3.5 mq of Tc-labeled tin colloid was endoscopically... more
Background/aims: Five patients having early gastric cancer were treated using laparoscopic partial gastrectomy combined with sentinel lymph node biopsy. Methodology: Preoperatively, 3.5 mq of Tc-labeled tin colloid was endoscopically injected near the tumor. Under general anesthesia, laparoscopic partial gastrectomy was then performed. Radioisotope (RI)-positive nodes were explored before performing laparoscopic partial gastrectomy. Results: An average of 2.6 sentinel nodes was detected in this way. All patients were found to be free from nodal involvement both histologically and immunohistologically during surgery. Four patients had mucosal cancer and one patient had submucosal cancer, which agreed with the preoperative diagnosis of tumor depth. Conclusions: Sentinel node biopsy in conjunction with laparoscopy in early gastric cancer surgery may allow confirmation of complete removal of risk nodes in early gastric cancer.
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ABSTRACT BackgroundAs the result of the development of imaging means, the incidence of discovery of superficial esophageal squamous cell cancer (ESCC) has recently increased. Various treatment methods such as endoscopic mucosal resection... more
ABSTRACT BackgroundAs the result of the development of imaging means, the incidence of discovery of superficial esophageal squamous cell cancer (ESCC) has recently increased. Various treatment methods such as endoscopic mucosal resection and reduction of lymphadenectomy have been performed to preserve the quality of life. Because lymph node metastasis occurs even in the early stage of esophageal cancer, we should carefully select the treatment method, including lymphadenectomy. MethodsWe analyzed the distribution of solitary lymph metastasis of 27 superficial esophageal cancers. To analyze the distribution of micrometastasis, a total of 1542 lymph nodes obtained from 46 patients with pN0 submucosal cancer were immunohistochemically examined by cytokeratin antibody. Sentinel node mapping was performed in 23 patients with clinical T1 tumors. ResultsThe location of lymph node metastasis in the 22 patients with solitary lymph metastasis in superficial cancer was limited to recurrent nerve nodes in the upper thoracic esophagus, recurrent nerve nodes, paraesophageal nodes, or perigastric nodes in the middle or lower thoracic esophagus. For eight patients with lymph node micrometastasis in pN0 patients with superficial esophageal cancer, the locations of micrometastasis were similar to those of solitary metastasis. In sentinel node mapping, all nodal metastasis was included in sentinel nodes with a single exception. ConclusionsIndividual lymphadenectomy in superficial ESCC will be established using methods such as analysis of past data, clinical diagnosis of lymph node metastasis by imaging, and sentinel node navigation surgery, including the diagnosis of micrometastasis.
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ABSTRACT A 62-year-old man was admitted to our hospital for dysphagia, leukocytosis, and pyrexia. The serum level of granulocyte colony-stimulating factor (G-CSF) was high and immunostaining of a biopsy specimen of esophageal tumor using... more
ABSTRACT A 62-year-old man was admitted to our hospital for dysphagia, leukocytosis, and pyrexia. The serum level of granulocyte colony-stimulating factor (G-CSF) was high and immunostaining of a biopsy specimen of esophageal tumor using anti-granulocyte-macrophage colony-stimulating factor (anti-GM-CSF) antibody demonstrated GM-CSF expression in the cytoplasm of the tumor cells. After esophagectomy, the leukocyte count and serum G-CSF level normalized. Histologically, this tumor was diagnosed as a carcinosarcoma with two components: squamous cell carcinoma and sarcoma. Tumor cells were also positive for G-CSF receptor, suggesting autocrine growth regulation by G-CSF. Moreover, tumor cells were positive for Ki-67, cyclin D1, p53, and epidermal growth factor receptor (EGFR), which were related to the acquisition of more aggressive tumor behavior. Although G-CSF-producing esophageal carcinosarcoma is very rare, we should consider such disease when a patient has symptoms of leukemia such as leukocytosis and high fever.
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Research Interests: Oncology, Molecular Medicine, Cancer, Biology, Cell Cycle, and 15 moreCell Adhesion, Immunohistochemistry, Apoptosis, Medicine, Adhesion, Humans, Female, Cell, Male, Gene, Aged, Middle Aged, Prognosis, Cadherin, and Cadherins
Recent research has revealed that tumor cells expressing chemokine receptors have a crucial impact on patient survival. However, there is no information regarding chemokine expression in gastro-intestinal cancer. This study... more
Recent research has revealed that tumor cells expressing chemokine receptors have a crucial impact on patient survival. However, there is no information regarding chemokine expression in gastro-intestinal cancer. This study immunohistochemically investigated CXCL12 expression in gastric cancer and evaluated its association with clinical factors, including patient prognosis. A total of 185 gastric cancer patients receiving curative gastrectomy were assessed. CXCL12 expression was evaluated by immunohistochemical analysis. Tumors with CXCL12-positive cancer cells were regarded as CXCL12 positive, and according to the degree of CXCL12 expression, patients were divided into three groups (weak, 31 cases; moderate, 27 cases; strong, 20 cases). Correlations between CXCL12 expression and clinical factors in gastric cancer were then determined. CXCL12 was found in the cellular membrane of cancer cells. Seventy-four of 185 patients were classified into the CXCL12-positive group. Patients were divided into three groups according to the positivity of CXCL12 expression. Significant associations between CXCL12 and lymph node metastases (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05), depth of invasion (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01), lymphatic invasion (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01), tumor diameter (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05), and clinical stage (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01) were seen. Univariate analysis revealed that the CXCL12-positive group had significantly poorer surgical outcome than the CXCL12-negative group (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01). Multivariate analysis revealed CXCL12 to be an independent prognostic factor in gastric cancer (p = 0.02). Cancerous CXCL12 positivity was determined to be an independent prognostic factor in gastric cancer, with CXCL12-positive gastric cancer showing more-aggressive behavior. Autocrine CXCL12 secretion from tumor cells may activate CXCR-4 on the tumor cells, which may be related to of the viability of distant metastases.
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Research Interests: Biology, Cancer Research, Medicine, Multivariate Analysis, Humans, and 12 moreInternal Medicine, Female, Male, Squamous Cell Carcinoma, Recurrence, Oral Squamous Cell Carcinoma (OSCC), Carcinogenesis, Analysis of Variance, Prognosis, Ribonucleotide Reductase, Cell Cycle Proteins, and Neoplasm staging
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Research Interests: Oncology, Immunohistochemistry, Medicine, Humans, Internal Medicine, and 13 moreFemale, Male, Squamous Cell Carcinoma, Esophageal Cancer, Aged, Middle Aged, Oral Squamous Cell Carcinoma (OSCC), Carcinoma, Proportional hazards model, Prognosis, esophageal carcinoma, Immunohistochemical Staining, and Cyclooxygenase
Research Interests: Pathology, Immunohistochemistry, Surgical Oncology, Metastasis, Medicine, and 15 moreHumans, Female, Male, Squamous Cell Carcinoma, Esophageal Cancer, Aged, Middle Aged, Oral Squamous Cell Carcinoma (OSCC), Adult, Retrospective Studies, Lymph Node, Cytokeratin, Micrometastasis, lymph node metastasis, and esophagectomy
Research Interests: Biology, Survival Analysis, Immunohistochemistry, Transcription Factors, Medicine, and 14 moreMultivariate Analysis, Humans, Female, Male, Squamous Cell Carcinoma, Aged, Middle Aged, Oral Squamous Cell Carcinoma (OSCC), Neoplasm Invasiveness, Prognosis, Cadherin, Slug, Cadherins, and Neoplasm staging
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To clarify the clinical implications of intraoperative carcinoembryonic antigen (CEA) mRNA copy number in peripheral blood samples from gastric cancer patients. Blood samples were obtained from 67 gastric cancer patients immediately after... more
To clarify the clinical implications of intraoperative carcinoembryonic antigen (CEA) mRNA copy number in peripheral blood samples from gastric cancer patients. Blood samples were obtained from 67 gastric cancer patients immediately after curative gastrectomy. mRNA in blood samples was extracted and amplified for CEA mRNA detection. CEA mRNA levels were examined by real-time reverse transcriptase-polymerase chain reaction (RT-PCR) assay targeting CEA mRNA. Thirty-three of 67 patients (49%) were positive for CEA mRNA expression. Positivity for CEA mRNA was not correlated with clinical stage, or presence or absence of postoperative relapse. CEA mRNA copy number was not correlated with serum levels of CEA. However, CEA mRNA copy number was correlated with presence or absence of tumor recurrence (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01). When confined to 21 gastric cancer patients with relapsed disease, CEA mRNA copy number was significantly and negatively correlated with postoperative period before recurrence discovery (r = 0.52, P = 0.007). Outcomes in patients with high CEA mRNA copy number and high serum CEA levels were significantly poorer than those in patients with normal CEA mRNA copy number and normal serum CEA levels (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01). CEA mRNA copy number, not positivity, was significantly associated with postoperative term of recurrent disease. Copy number of CEA mRNA, as detected by real-time quantitative PCR, appears to be a promising marker to evaluate the risk and period of postoperative tumor spread.
Research Interests: Cancer, Medicine, Humans, Female, Gastric Cancer, and 14 moreMale, Recurrence, Clinical Sciences, Aged, Middle Aged, Retrospective Studies, Prognosis, Sensitivity and Specificity, Surgical, Carcinoembryonic Antigen, Predictive value of tests, real time polymerase chain reaction, Disease Free Survival, and Stomach neoplasms
The purpose of the present study was to analyze clinicopathologic variables in esophageal squamous cell carcinoma (ESCC) according to expression of E-cadherin and alpha-catenin which play an important role in cell adhesion. We... more
The purpose of the present study was to analyze clinicopathologic variables in esophageal squamous cell carcinoma (ESCC) according to expression of E-cadherin and alpha-catenin which play an important role in cell adhesion. We immunohistochemically examined E-cadherin and alpha-catenin in 205 patients with ESCC. The expression results were classified into two groups: preserved expression (+) and reduced expression (-). The incidence of E-cadherin (-) and alpha-catenin (-) was 52% and 54%, respectively and significantly related each other. For both E-cadherin and alpha-catenin, reduced expression was significantly related to tumor depth, nodal metastasis, stage, recurrence, and prognosis. In the E-cadherin (+) group, the alpha-catenin (+) and alpha-catenin (-) patients differed significantly in tumor depth, nodal metastasis, stage, hematogenous and lymphatic recurrences (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001, &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001, &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001, &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001 and =0.007, respectively). According to coexpression of E-cadherin and alpha-catenin, the prognosis was best in patients with E-cadherin (+) and alpha-catenin (+), and worst in patients with E-cadherin (-) and alpha-catenin (-). Multivariate analysis revealed that alpha-catenin expression was an independent prognostic factor. The examination of expression of E-cadherin and especially alpha-catenin is useful for predicting lymph node metastasis and clinical outcome of ESCC.