Moreover, tumor budding displaying a spindle‐like morphology is associated with decreased expression of E‐cadherin and increased expression of ZEB1.19 In ESCC, the EMT status, defined as a high vimentin to E‐cadherin RNA expression ratio in cancerous tissues, is associated with tumor budding.37 Further studies are required to establish the biological and clinical significance of tumor budding in this highly aggressive disease. This evidence concerns the gene ZEB1 and esophageal squamous cell carcinoma.