Suzuki L, et al. - In order to assess the informative biomarker that could accurately predict the presence of lymph node metastases (LNM) in esophageal adenocarcinoma (EAC), researchers examined Olfactomedin 4 (OLFM4), an intestinal stem cell marker, for its discriminative value in EAC. From an institutional database (Erasmus MC University Medical Center, Rotterdam, The Netherlands), they selected patients who had undergone esophagectomy as single treatment modality for both advanced (pT2-4) and early (pT1b) adenocarcinoma of the esophagus or gastro-esophageal junction. OLFM4 expression was studied in surgical resection specimens of 196 advanced and 44 early EAC by immunohistochemistry and categorized as low (<30%) or high (> = 30%) expression. Both advanced and early EAC displayed poor differentiation grade in correlation to low OLFM4. The multivariable analysis suggested that in advanced EAC but not in early EAC, low OLFM4 was independently associated with the presence of LNM. Findings thereby support the possible value of OLFM4 as an informative marker with the potential to improve preoperative assessment in patients with EAC.