Purpose The authors aimed to evaluate the prognostic value of thrombin receptor (TR) expression in microvessel endothelial cells (VECs) by coagulation state in oesophageal squamous cell carcinoma (ESCC).

Methods In 138 ESCC normal and para-tumour samples, we investigated the association of the expression of TR and CD34 (microvessel marker) seen on immunohistochemical staining and clinicopathological parameters, coagulation state, microvessel density (MVD), and survival of patients.

Result In total, 62 ESCC tissues were positive for TR in VECs, and in 48 cases, the activated partial thromboplastin time (APTT) was <28.5 s, with significant difference in tumour depth between TR-positive and -negative cases with APTT<28.5 s. Also with APTT<28.5 s, TR-positive MVD (TRMVD) was significantly greater with high than low CD34-positive MVD (CD34MVD; 7.96±4.27 vs 5.64±2.99; p=0.032). High CD34MVD was associated with increased TR expression in patients with APTT<28.5 than ≥28.5 s. In patients with high CD34MVD, the number of TR-positive microvessels was greater with APTT<28.5 than ≥28.5 s (n=17 vs n=6; p=0.002), and APTT and TR expressions were negatively correlated for patients with APTT<28.5 s (r² =−0.472, p=0.023). For patients with APTT<28.5 s, the cumulative survival rate was poorer with high than low TRMVD (p=0.027). On multivariate analysis, tumour size (p=0.006), tumour stage (p=0.004) and TRMVD (p=0.024) were independently associated with survival for patients with APTT<28.5 s. TRMVD had the second highest HR.

Conclusion TR positivity in VECs may be an adverse prognostic factor for patients with ESCC and increased coagulation state. TR expression in VECs might be related to angiogenesis in ESCC.