|Year : 2015 | Volume
| Issue : 2 | Page : 277-279
Expression of elastic fiber in esophageal squamous carcinoma tissue
Akshay Chandra Deka1, Vidhya Srinivasan1, Ananta Madhab Dutta2, Pratap Chandra Sarma1
1 Department of Pathology, Assam Down Town University, Panikhaiti, Guwahati, Assam, India
2 Department of Chemistry, Assam Down Town University, Panikhaiti, Guwahati, Assam, India
|Date of Web Publication||7-Jul-2015|
Akshay Chandra Deka
Department of Pathology, Assam Down Town University, Panikhaiti, Guwahati - 781 026, Assam
Source of Support: None, Conflict of Interest: None
Aim: We studied the expression of elastic fiber in esophageal squamous cell carcinoma tissue in North-eastern Indian population.
Materials and Methods: Archival paraffin embedded 40 esophageal carcinoma specimens were retrieved for the study. Only smokers were included in the study. Verhoeff's stain for elastic fiber was performed to demonstrate elastic fiber with positive and negative control.
Result: A total of 28 (70%) tissue specimens was found to be positive for elastic fiber.
Conclusion: Elastosis in esophageal carcinoma may be due to smoking. Further studies are required to rule out the etiology.
Keywords: Elastosis, esophageal squamous cell carcinoma, smokers, Verhoeff′s stain
|How to cite this article:|
Deka AC, Srinivasan V, Dutta AM, Sarma PC. Expression of elastic fiber in esophageal squamous carcinoma tissue. J Can Res Ther 2015;11:277-9
| > Introduction|| |
The global burden of cancer is increasing; this is considered to be largely due to change in lifestyle, an increasing adoption of cancer-causing behaviors and exposure to carcinogens in the environment. Based on International Agency for Research on Cancer statistics, 12.7 million cancer cases are diagnosed, and 7.6 million cancer deaths are estimated worldwide.  Esophageal cancer is the sixth most common cause of cancer-related deaths with an estimated incidence of 482,300 new cases and 406,800 deaths every year. 
Etiology of esophageal cancer is not yet clear, but it is a multi-step progressive process. Major risk factors for esophageal cancer are not well-characterized but may include poor nutritional status, low intake of fruits and vegetables, drinking beverages at high temperatures, tobacco usage, and alcohol consumption. ,, Tobacco and/or alcohol account for approximately 90% of all esophageal squamous cell carcinomas. Tobacco smoking is also linked to esophageal adenocarcinoma though no scientific evidence has been found between alcohol and esophageal adenocarcinoma. Exogenous agents such as coffee, tobacco, alcohol, and nonvegetarian diet affect the methylation status of specific gene promoters in esophageal tissue and trigger epigenetic changes which may initiate the carcinogenic process. ,
The disease is more common in men than woman and seen in elderly age.  Heredity - it is more likely in people who have close relatives with cancer. Obesity increases the risk of adenocarcinoma four-fold. , Thermal injury as a result of drinking hot beverages. , Alcohol consumption in individuals predisposed to alcohol flush reaction.  Human papillomavirus. 
Smoking is an independent risk factor for the increase of elastic fibers in the reticular dermis of nonexposed skin, and it acts on their two main structural components, elastin and microfibrillar component. This increase in the area of elastic fibers in smokers is not due to newly synthesized elastic material, but to their degradation, as occurs in solar elastosis and which acts in an additive manner. , While smoking people take the smoke to lung via esophagus and release it after that. Hence, there may be an expression of elastic fiber in esophageal cancer tissue of smoker. Hence, we studied the expression of elastic fiber in esophageal cancer tissue for smokers.
Materials and Methods
A total of 40 specimens of esophageal squamous cell carcinoma tissue was selected for the study. Archival paraffin blocks were obtained from histopathology laboratory of downtown hospital laboratory for the study. Four micrometer sections were cut from each tissue blocks and stained with h and e and examined for the confirmation of the diagnosis. After diagnosis had been confirmed, the tissue was selected for the study. Smoking history of the patients was taken. All the specimens were from smokers who developed esophageal squamous cell carcinoma in later life. Esophageal cancers of nonsmokers were excluded from the study. Thirty-two tissues were from male smokers, and 8 tissues were from female who eat beetle-nut and tobacco.
We have taken disease free esophageal tissue as negative control and pterygium tissues were used as a positive control. All the tissues were fixed in 10% neutral buffered formalin, processed routinely and embedded in paraffin wax. Esophageal elastic fiber expression has been demonstrated by presence of elastic fiber by applying the elastic stain (Merck, Germany) using Verhoeff's technique, the abnormal pseudoelastic material appears as dark brown wavy stripes.
| > Result|| |
A total of 40 tissue specimens diagnosed as having esophageal squamous carcinoma in a hospital from North-eastern region were studied for the presence of elastic fiber in archival paraffin-embedded tissue sections. Of 40 specimens, 32 were males, and 8 were females with a mean age of 53.7 years.
Twenty-eight specimens (70%) were found to be positive and 12 (30%) specimens were negative for elastic fiber in the esophageal tissue sections. Positive control, pterygium tissues, and skin tissues were found to be positive, and disease free esophageal tissues were negative for elastic stain. Each set of Verhoeff's stain was done using one positive control and one negative control slide. [Figure 1] and [Figure 2] show a positive and negative elastic stain from esophageal squamous cell carcinoma tissue. Thirty-two tissue specimens were taken from the patients, professional farmer, and 8 from government service holder. All the patients were smokers.
| > Discussion|| |
Ultraviolet (UV) and smoking may lead to elastosis, the breakdown of elastin and collagen under the surface of the skin, conjunctiva  demonstrated clinically by deep wrinkles and histologically by tangled fibers. Kennedy et al. studied 966 individual and said that smoking and UV radiation has a detrimental effect on human skin, and important characteristics of the aging skin are elastosis and telangiectasia. Lifetime sun exposure is also significantly associated with the development of telangiectasia although the strength of the association appeared to be less strong among women. Smoking is significantly associated with elastosis and telangiectasia, although the association appeared to be more pronounced among men than women. , Smoking is having impact on estrogenic efficacy, cancer of the uterus, breast cancer, lung cancer, etc. ,, In vitro studies indicate that tobacco smoke extract impairs the production of collagen and increases the production of tropoelastin and matrix metalloproteinases (MMP), which degrade matrix proteins, and also causes an abnormal production of elastosis material. Smoking increases MMP levels, which leads to the degradation of collagen, elastic fibers, and proteoglycans, suggesting an imbalance between biosynthesis and degradation in connective tissue metabolism.  Francès et al. studied 10 biopsies from the upper and inner arm of 60-year-old male cigarette smokers and compared with 10 age-matched controls who were nonsmokers and found elastic fibers were significantly increased in the cigarette smokers compared to the controls and also confirmed that elastic fibers were similar to those in solar elastosis.  All those studies were not related esophageal cancer. This is the first study which showed 70% specimens were positive for elastic fiber in esophageal carcinoma tissue for smokers. This is a significant investigation which showed the presence of elastic fiber in esophageal tissue. The presence of elastic fiber is may be due to the collagen fiber degradation due to smoking.
| > Conclusion|| |
Smokers in our study seemed vulnerable to the development of elastosis. This increase in the area of elastic fibers in smokers is not due to newly synthesized elastic material, but to their degradation, as occurs in solar elastosis and which acts in an additive manner. Further studies are required to know more about smoking-induced elastosis.
| > Acknowledgment|| |
Support from downtown Charity Trust.
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[Figure 1], [Figure 2]