Journal of Pathology and Translational Medicine

Original Articles

Elevated expression of Axin2 in intestinal metaplasia and gastric cancers: Dong Hui Lee, In Ho Jeong, Bogun Jang; J Pathol Transl Med. 2023;57(6):315-322. Published online November 7, 2023; DOI: https://doi.org/10.4132/jptm.2023.10.12

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Abstract PDF: Background
The Wnt signaling pathway regulates crucial cellular processes, including stem cell development and tissue repair. Dysregulation of this pathway, particularly β-catenin stabilization, is linked to colorectal carcinoma and other tumors. Axin2, a critical component in the pathway, plays a role in β-catenin regulation. This study examines Axin2 expression in normal gastric mucosa and various gastric pathologies.
Methods
Formalin-fixed and paraffin-embedded tissue samples from normal stomach, gastritis, intestinal metaplasia (IM), and gastric carcinoma were collected. Axin2 and β-catenin expression were evaluated using RNA in situ hybridization and immunohistochemistry, respectively. Histo-scores (H-scores) were calculated to quantify expression levels of Axin2. Associations between Axin2 expression and clinicopathological variables were examined.
Results
Axin2 expression was examined in normal stomach, gastritis, and IM tissues. Axin2 expression was mainly observed in the surface and isthmus areas in the normal stomach and gastritis, whereas Axin2 expression was markedly higher at the bases of IM. Axin2 H-scores were significantly elevated in IM (mean ± standard deviation [SD], 87.0 ± 38.9) compared to normal (mean ± SD, 18.0 ± 4.5) and gastritis tissues (mean ± SD, 33.0 ± 18.6). In total, 30% of gastric carcinomas showed higher Axin2 expression. Axin2 expression did not have significant associations with age, sex, Lauren classification, histological differentiation, invasion depth, and lymph node metastasis. However, a strong positive correlation was observed between Axin2 and nuclear β-catenin in gastric carcinomas (p < .001).
Conclusions
Axin2 expression was significantly increased in IM compared to normal and gastritis cases. In addition, Axin2 showed a strong positive association with nuclear β-catenin expression in gastric carcinomas, demonstrating a close relationship with abnormal Wnt/β-catenin signaling pathway.

MUC2 Expression Is Correlated with Tumor Differentiation and Inhibits Tumor Invasion in Gastric Carcinomas: A Systematic Review and Meta-analysis: Jung-Soo Pyo, Jin Hee Sohn, Guhyun Kang, Dong-Hoon Kim, Kyungeun Kim, In-Gu Do, Dong Hyun Kim; J Pathol Transl Med. 2015;49(3):249-256. Published online May 15, 2015; DOI: https://doi.org/10.4132/jptm.2015.03.27

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Background
While MUC2 is expressed in intestinal metaplasia and malignant lesions, the clinico-pathological significance of MUC2 expression is not fully elucidated in gastric carcinoma (GC). Methods: The present study investigated the correlation between MUC2 expression and clinico-pathological parameters in 167 human GCs. In addition, to confirm the clinicopathological significance of MUC2 expression, we performed a systematic review and meta-analysis in 1,832 GCs. Results: MUC2 expression was found in 58 of 167 GCs (34.7%). MUC2-expressing GC showed lower primary tumor (T), regional lymph node (N), and tumor node metastasis (TNM) stages compared with GCs without MUC2 expression (p=.001, p=.001, and p=.011, respectively). However, MUC2 expression was not correlated with Lauren’s classification and tumor differentiation. In meta-analysis, MUC2 expression was significantly correlated with differentiation and lower tumor stage (odds ratio [OR], 1.303; 95% confidence interval [CI], 1.020 to 1.664; p = .034 and OR, 1.352; 95% CI, 1.055 to 1.734; p = .017, respectively) but not with Lauren’s classification, pN stage, or pTNM stage. Conclusions: MUC2 expression was correlated with a lower tumor depth and lower lymph node metastasis in our study; the meta-analysis showed a correlation of MUC2 expression with tumor differentiation and lower tumor depth.

Citations

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Diagnostic gastrointestinal markers in primary lung cancer and pulmonary metastases
Karina Malmros, Andreas Lindholm, Halla Vidarsdottir, Karin Jirström, Björn Nodin, Johan Botling, Johanna S. M. Mattsson, Patrick Micke, Maria Planck, Mats Jönsson, Johan Staaf, Hans Brunnström
Virchows Archiv.2023;[Epub] CrossRef
Gastric epithelial histology and precancerous conditions
Hang Yang, Wen-Juan Yang, Bing Hu
World Journal of Gastrointestinal Oncology.2022; 14(2): 396. CrossRef
COX-2 strengthens the effects of acid and bile salts on human esophageal cells and Barrett esophageal cells
Shen Jiangang, Kang Nayoung, Wang Hongfang, Li Junda, Chen Li, Bai Xuefeng, Li Mingsong
BMC Molecular and Cell Biology.2022;[Epub] CrossRef
Comparative genomic analysis of primary tumors and paired brain metastases in lung cancer patients by whole exome sequencing: a pilot study
Pascale Tomasini, Fabrice Barlesi, Sophie Gilles, Isabelle Nanni-Metellus, Riccardo Soffietti, Emilie Denicolai, Eric Pellegrino, Emilie Bialecki, L’Houcine Ouafik, Philippe Metellus
Oncotarget.2020; 11(50): 4648. CrossRef
A High Ki67/BCL2 Index Could Predict Lower Disease-Free and Overall Survival in Intestinal-Type Gastric Cancer
Kyueng-Whan Min, Dong-Hoon Kim, Byoung Kwan Son, Dong Hyun Kim, Eun-Kyung Kim, Jinwon Seo, Sang Bong Ahn, Yun Ju Jo, Young Sook Park, Junghoon Ha
European Surgical Research.2017; 58(3-4): 158. CrossRef

Prognostic Significance of Heat Shock Protein 70 Expression in Early Gastric Carcinoma: Youngran Kang, Woon Yong Jung, Hyunjoo Lee, Wonkyung Jung, Eunjung Lee, Bong Kyung Shin, Aeree Kim, Han Kyeom Kim, Baek-hui Kim; Korean J Pathol. 2013;47(3):219-226. Published online June 25, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.3.219

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Abstract PDF

Background

Overexpression of heat shock protein 70 (HSP70) has been observed in many types of cancer including gastric adenocarcinomas, although the exact role of HSP70 in carcinogenesis remains unclear.

Methods

The study analyzed a total of 458 radical gastrectomy specimens which were immunohistochemically stained with HSP70, p53, and Ki-67 antibodies.

Results

The study determined that the expression of HSP70 was significantly increased in early gastric cancer (EGC) compared to advanced gastric cancer (p<0.001). The HSP70 expression was correlated with well-differentiated tumor type, intestinal type of Lauren classification and the lower pT and pN stage. Negative expression of Ki-67 and p53 expression was associated with poor prognosis. The study did not find any correlation between HSP70 and p53 expression. The study determined that HSP70 expression in the EGC subgroup was associated with a poor prognosis (p=0.009), as well as negative Ki-67 expression (p=0.006), but was not associated with p53. Based on multivariate analysis, HSP70 expression (p=0.024), negative expression of Ki-67, invasion depth and lymph node metastasis were determined to be independent prognostic markers.

Conclusions

HSP70 is expressed in the early stages of gastric adenocarcinoma. In EGC, HSP70 is a poor independent prognostic marker and is correlated with a low proliferation index.

Citations

Citations to this article as recorded by

The Prognostic Importance of Ki-67 in Gastrointestinal Carcinomas: A Meta-analysis and Multi-omics Approach
Mahdieh Razmi, Fatemeh Tajik, Farideh Hashemi, Ayna Yazdanpanah, Fatemeh Hashemi-Niasari, Adeleh Divsalar
Journal of Gastrointestinal Cancer.2024;[Epub] CrossRef
Clinicopathological significance of HSP70 expression in gastric cancer: a systematic review and meta-analysis
Xiaolu Wang, Li Xie, Lijing Zhu
BMC Gastroenterology.2021;[Epub] CrossRef
Beta-sheet-specific interactions with heat shock proteins define a mechanism of delayed tumor cell death in response to HAMLET
Aftab Nadeem, James C.S. Ho, Tuan Hiep Tran, Sanchari Paul, Victoria Granqvist, Nadege Despretz, Catharina Svanborg
Journal of Molecular Biology.2019; 431(14): 2612. CrossRef
Evolving paradigms on the interplay of mitochondrial Hsp70 chaperone system in cell survival and senescence
Shubhi Srivastava, Vinaya Vishwanathan, Abhijit Birje, Devanjan Sinha, Patrick D’Silva
Critical Reviews in Biochemistry and Molecular Biology.2019; 54(6): 517. CrossRef
Clinicopathologic significance and prognostic value of Ki-67 expression in patients with gastric cancer: a meta-analysis
Guanying Luo, Yunzhao Hu, Zhiqiao Zhang, Peng Wang, Zhaowen Luo, Jinxin Lin, Canchang Cheng, You Yang
Oncotarget.2017; 8(30): 50273. CrossRef
Extracellular HSP70-peptide complexes promote the proliferation of hepatocellular carcinoma cells via TLR2/4/JNK1/2MAPK pathway
Yi Zhe, Yan Li, Dan Liu, Dong-Ming Su, Jin-Gang Liu, Hang-Yu Li
Tumor Biology.2016; 37(10): 13951. CrossRef
The cytomegalovirus protein UL138 induces apoptosis of gastric cancer cells by binding to heat shock protein 70
Wenjing Chen, Kezhi Lin, Liang Zhang, Gangqiang Guo, Xiangwei Sun, Jing Chen, Lulu Ye, Sisi Ye, Chenchen Mao, Jianfeng Xu, Lifang Zhang, Lubin Jiang, Xian Shen, Xiangyang Xue
Oncotarget.2016; 7(5): 5630. CrossRef
Targeting the hsp70 gene delays mammary tumor initiation and inhibits tumor cell metastasis
J Gong, D Weng, T Eguchi, A Murshid, M Y Sherman, B Song, S K Calderwood
Oncogene.2015; 34(43): 5460. CrossRef

Gastric Carcinoma with Lymphoid Stroma: Pathologic and immunohistochemical study of 14 cases.: Eun Hee Lee, Woo Young Jang, Kyoung Chan Choi, Young Ran Shim, Joon Hyuk Choi, Won Hee Choi; Korean J Pathol. 1996;30(2):115-120.

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Abstract PDF: A total of 672 surgically resected gastric carcinomas were reviewed, and fourteen cases(2.1%) of "gastric carcinoma with lymphoid stroma" were identified. The tumor was located mostly in cardia and body portion(86%). Thirteen patients one was lost to follow up were alive without recurrence of tumor. Grossly, this carcinoma was characterized by an expanding growth pattern or a multinodular pattern. Histologically, this carcinoma showed an irregular trabecular and alveolar arrangement and densely infiltrated lymphoid cells with lymph follicles. The tumor cell nests were widely separated by non-desmoplastic lymphoid stroma. On immunohistochemical study, T cells were evenly distributed throughout the tumor lesion with intimate contact with individual carcinoma cells, but B cells were mainly present within the germinal centers of lymph follicles. Thus, the organized immune response combined with cell mediated and humoral immunities against the carcinoma cells may be a defense mechanism of the host in this type of gastric carcinoma.

Expression of nm23 Protein in Human Gastric Carcinoma: correlation between nm23 expression with the development and metastasis of gastric carcinoma.: Jin Hee Sohn, Hye Rym Park, Young Oui Park; Korean J Pathol. 1996;30(6):487-494.

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Abstract PDF: Gene expression of nm23 has been investigated in many kinds of tumors, including breast cancers, colon cancers, hepatocellular carcinomas, papillary carcinomas of the thyroid and malignant melanomas since the nm23 was dislovered by Dr. Steeg as a tumor metastatic suppressor gene. Reduced expression of nm23 gene implicated in high metastatic potential in a variety of malignancies. However, there have been only a few reports on genetic alteration and expression of nm23 in human gastric carcinomas even though gastric carcinoma is a leading malignancy in Korea. In this study, we examined the expression of nm23 protein by immunohistochemistry in advanced and early gastric carcinomas, adenomas, matching normal mucosa to elucidate the role of nm23 in the development, progression and metastasis of human gastric carcinomas. The results are as follows; 1) Nm23 was expressed in 39 cases(69.6%) of 56 advanced gastric carcinomas. Among them, strong positive cases(grade 3) were 26(46.4%) and weak positive cases(grade 2) were 13(23.2%). 2) Nm23 expression was significantly different (P<0.05) depending on the site of the neoplasm. Antral carcinomas showed grade3 positivity in the 22/37 cases(60%), but carcinomas of the body showed negative (grade 1) result in about half(42.1%). 3) Nm23 expression was more intense in the neoplasm than normal mucosa.(67.9%) 4) Nm23 expression was not significantly related to the lymph node metastasis, invasion of lymphatics or veins and depth of invasion. 5) In the well differentiated carcinomas, grade3 were more common(64.0%). But in cases of signet ring cell carcinoma, many cases were negative(50.0%). 6) Nm23 expression rate and intensity was significantly increased from the normal mucosa to the gastric adenomas, early gastric carcinomas and advanced gastric carcinomas.

Immunohistochemical Study of the Vascular Endothelial Growth Factor in Gastric Carcinoma.: Tae Jung Jang, Jung Ran Kim; Korean J Pathol. 1997;31(5):401-409.

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Abstract PDF: Many studies have shown that angiogenesis plays an important role in the growth, the progression, and the metastasis of a solid tumor. The vascular endothelial growth factor(VEGF) is thought to be a selective mitogen for endothelial cells. Twenty eight advanced gastric carcinomas and twenty early gastric carcinomas were investigated by staining with polyclonal antibody against the VEGF. Correlation between the expression of the VEGF and the clinicopathologic features of gastric carcinoma were studied. The VEGF was mainly localized to the cytoplasm of carcinoma cells. Normal gastric foveolar epithelium was not immunoreactive, but some endothelial cells were weakly immunoreactive with an anti-VEGF antibody. Expression of the VEGF was significantly higher in advanced gastric carcinoma than in early gastric carcinoma (p=0.003). Expression of the VEGF was correlated with the depth of tumor, the lymph node metastasis, and the stage (p<0.05). The VEGF positivity was significantly higher in moderately and poorly differentiated gastric carcinoma than in well differentiated gastric carcinoma. The VEGF scores of the metastatic foci in the lymph nodes were higher than that of the primary tumors, which were followed by deep and superficial portions of the primary tumors in a descending order (p<0.05). In summary, the expression of the VEGF may be associated with progression and metastasis of a gastric carcinoma and may also be a good prognostic factor in a gastric carcinoma.

Immunohistochemical Study of E-cadherin Expression in Gastric Adenocarcinomas.: Jee Yeon Kim, Mee Young Sol, Sun Kyung Lee; Korean J Pathol. 1997;31(8):745-753.

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Abstract PDF: E-cadherin (ECD) is a Ca++ -dependent adhesion molecule which plays a major role in the maintenance of intercellular adhesion in epithelial tissues. The expression pattern of ECD in 77 surgically resected gastric adenocarcinomas was examined by immunohistochemistry, using a rat monoclonal antibody raised against murine E-cadherin (DECAM-1). ECD was strongly expressed uniformly at cell to cell borders in normal gastric epithelium without exception. But, various staining patterns were observed in the cancer tissues. The frequency of tumors with preserved ECD expression (Pre-type) and reduced ECD expression (Rd-type) was 44% and 56%, respectively. Using Lauren's classification, the high frequency of the Pre-type expression in adenocarcinoma of the intestinal type was significantly higher than that in adenocarcinoma of the diffuse type (p<0.05). But, no significant correlation between the ECD expression and the gross type, invasion depth, growth pattern or metastasis was observed. These results suggest that ECD might play a key role in the morphogenesis of gastric adenocarcinoma.

A Study of the Correlation between Prognostic Factors of Human Gastric Carcinomas and the Expression of CD44.: Ho Lee, Hyung Chul Kim, Woo Sung Moon, Myoung Jae Kang; Korean J Pathol. 1997;31(9):873-883.

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Abstract PDF: This study was performed to investigate the relationship between CD44 expression and depth of, tumor invasion histopathologic differentiation, tumor size, lymph node metastasis, and proliferating capacity of tumor cells in the gastric carcinoma. In 20 cases of early gastric carcinoma (EGC) and 40 cases of advanced gastric carcinoma (AGC), the immunohistochemical staining for CD44v3, CD44v5, and PCNA gave the following results. 1) In all 60 cases, the positive rates for CD44v3 and CD44v5 were 18.3% and 71.7%, respectively. 2) CD44v5 was expressed in 45% of EGC and 85% of AGC. 3) Larger tumors exhibited higher positive rates for CD44v5. 4) There were 28 cases of lymph node metastases out of 43 cases of CD44v5- positive primary gastric carcinomas (65.1%), and there were 4 cases of lymph node metastases out of 17 CD44v5-negative cases (23.5%). 5) There was no relationship between CD44v5 expression and PCNA index. Because the tumors that exhibit deep invasion, and large in size and have lymph node metastses tend to have more frequent expression of CD44v5, CD44v5 may be one of the useful prognostic markers for gastric carcinoma.

Correlation between p53 Immunohistochemical Expression, DNA Ploidy and Ki-67 Expression in Gastric Carcinoma.: Young Lyun Oh, Joung Ho Han, Young Hyeh Ko, Cheol Keun Park, Hwoe J Ree; Korean J Pathol. 1997;31(12):1264-1271.

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Abstract PDF: We examined the p53 protein overexpression and evaluated its correlation with pathobiological variables, including: (1) patient age, sex, tumor size, histological type and grade, invasion depth, vascular invasion, perineural invasion and lymph node status; (2) the Ki-67 labeling index in 100 gastric carcinomas; and (3) the DNA ploidy pattern, S phase fraction (SPF), and the proliferation index (PI) in 84 cases using flow cytometry. The positive rate of p53 staining was 48% and the p53 immunoreactivity was independent of variable clinicopathologic factors. No correlation was made between the Ki-67 labeling index with p53 immunostaining and DNA ploidy parameters. Aneuploidy rate was slightly higher in the p53 positive group (55.6%) than the p53 negative group (44.4%)(p=0.097). The mean values of SPF and PI were significantly higher in the p53 protein positive group. Aneuploidy was more often observed in the intestinal type (p=0.038), advanced gastric carcinoma (p=0.015) and lymph node positive group(p=0.039). The above results suggest that although the p53 protein overexpression has no significant correlation with pathological factors and the Ki-67 labeling index, it may play an important role in tumor cell proliferation. Since p53 protein overexpression was slightly higher in the aneuploidy group showing significant correlation with poor prognostic parameters, it is thought that re-evaluation of the p53 mutation by molecular biological study is needed.

A Comparative Study of Immunohistochemistry and PCR-SSCP for Detection of p53 Mutation In Gastric Carcinoma.: Jong Soon Kim, Jae Hyuk Lee, Min Cheol Lee, Chang Soo Park, Sang Woo Juhung; Korean J Pathol. 1998;32(1):21-28.

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Abstract PDF: Mutation of the p53 tumor-suppressor gene in exons 4 through 9 was examined in 34 cases of primary advanced gastric cancer using PCR-SSCP (polymerase chain reaction-single strand conformation polymorphism) and the results were compared with p53 protein expression as determined by immunohistochemistry (IHC) using a monoclonal antibody(DO-1). p53 protein detected by IHC was observed in 14 cases (41.2%) and genotypic mutation detected by PCR-SSCP in exons 4-9 was observed in 13 cases (38.2%) One case showed an aberrant band on PCR-SSCP both in Exon 7 and Exon 8/9. p53 alteration detected by either IHC or PCR-SSCP was observed in 19 cases (55.9%), but only 8 cases (23.5%) showed both p53 mutation and protein expression. We also tried to obtain the correlation between relative intensity of the shifted bands on PCR-SSCP and percentage of positive cells by IHC, but a significant correlation was not seen between relative intensity of shifted bands on PCR-SSCP and positve cell ratio. A discrepancy between p53 protein expression and p53 mutation is observed in primary gastric carcinomas. The reason for this discrepancy are not apparent. However, examination of gastric carcinomas for mutations in other exons may identify a better correlation with protein overexpression. The results obtained in this study suggest that the negative reaction for p53 immunohistochemistry may not necessarily mean no genetic alteration of the p53 locus.

Expression of Transforming Growth Factor-beta1 and Its Effects on the Extracellular Matrix Formation and Angiogenesis in Gastric Carcinoma.: Young Hee Choi, Young Euy Park; Korean J Pathol. 1998;32(9):647-654.

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Abstract: Malignant cells in culture express elevated levels of transforming growth factor-beta1 (TGF-beta1) mRNA and secrete an abundant amount of the TGF-beta1 protein. An attempt was made to define the role of the TGF-beta1 secreted from tumor cells, as a possible humoral factor which functions in a paracrine manner to stimulate the production of collagen and angiogenesis in gastric carcinoma. The expression of the TGF-beta1 by immunohistochemical stain (n=70) in gastric adenocarcinoma tissues was studied. Angiogenesis was evaluated by immunohistochemical staining of tumor vessels, using polyclonal antibody to factor VIII related antigen and counting the three most active areas of neovascularization. The extracellular matrix was counted as area density by using an image analyzer following Masson-Trichrome staining. The prominent reactivity for TGF-beta1 was associated with invasion depth (r=0.2, p<0.05), increased number of microvessel (r=0.49, p<0.05) and increased area density of extracellular matrix (r=0.36, p<0.05), respectively. In summary, TGF-beta1 may have a role in tumor invasion and metastasis by increased angiogenesis and deposits of extracellular matrix.

Alterations of the Mucin Glycoprotein Expression and Their Relationship with the Pathologic Prognostic Factors in Gastric Carcinoma.: Mee Sook Roh, Gi Yeong Huh, Sook Hee Hong; Korean J Pathol. 1999;33(1):15-24.

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Abstract: Alterations of the mucin-type glycoproteins may contribute to changes in cancer cell growth regulation, immune regulation, and cellular adhesion, which in turn may influence the invasive and metastatic capabilities of the cancer. Many of the cancer-associated antigens such as mucin antigens have been identified recently and alterations in the glycosylation of the mucins have been described in the cancer. Immunohistochemical studies of 3 antigens associated with alteration of the mucin glycoprotein (MUC1, MUC2, STn) were done to evaluate their relationship with known pathologic prognostic factors and their usefulness in assessment of the progression of gastric carcinoma in 127 gastric carcinoma tissues. The MUC1 was detected in 57 (44.9%), MUC2 in 76 (59.8%) and STn antigen in 77 (60.6%) out of 127 cases of gastric carcinomas. The expression rate of MUC1 was significantly correlated with depth of tumor invasion, lymph node and distant metastases, and advanced tumor stage (p=0.001). The expression rate of MUC2 was not significantly correlated with pathologic findings and known prognostic factors. The STn antigen was significantly associated with incidence of lymph node metastasis (p=0.02). The coexpression of both MUC1 and MUC2 or MUC1 and STn was more frequent in tumors with deep invasion, lymph node metastasis and advanced tumor stage than one or none expression (p<0.05). These results suggest that the alterations of expression of the mucin proteins, especially MUC1 and carbohydrate antigen (STn) are associated with poor biological behavior of the gastric carcinoma.

Expression of Epidermal Growth Factor Related Peptides, EGF-R, and c-erbB-2 and Their Relationship with the Prognostic Factors in Gastric Carcinoma.: Joo Heon Kim, Jin Wook Lee, Woo Sung Moon, Myoung Jae Kang, Dong Geun Lee; Korean J Pathol. 1999;33(11):1039-1046.

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Abstract PDF: Recent investigations have revealed that autocrine growth factors and their receptors are closely related and play an important role in controlling cancer cell growth. We performed an immunohistochemical study on the expression of epidermal growth factor (EGF), transforming growth factor-alpha (TGF-alpha), epidermal growth factor receptor (EGF-R), c-erbB-2, and PCNA labelling index in 60 cases of human gastric carcinomas. TGF-alpha was detected in 38 cases (63.3%), EGF in 26 cases (43.3%), EGF-R in 44 cases (73.3%), and c-erbB-2 in 18 cases (30%). These growth factors, EGF-R and c-erbB-2, were found more often in advanced gastric cancers. The PCNA labeling index was significantly higher in tumors with the expression of EGF-R or c-erbB-2. Tumors with simultaneous expression of EGF, TGF-alpha, EGF-R and c-erbB-2 was associated with a high PCNA labeling index. A correlation was observed between the synchronous expression of growth factors and its receptors and histological differentiation. The results suggest that the expression of EGF, TGF-alpha, EGF-R and c-erbB-2 are closely related and plays an important role in the growth and progression of human gastric carcinoma.

Clinicopathologic Significance of Lymph Node Micrometastasis in Advanced Gastric Carcinoma.: Youngmee Kwon, Jae Y Ro, Gyeong Hoon Kang; Korean J Pathol. 2000;34(2):125-131.

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Abstract PDF: There have been some controversies on prognostic significance of lymph node (LN) micrometastasis (MM) in advanced gastric carcinomas (AGCs). The present study aimed at 1) determination of prognostic significance of MM, 2) evaluation of the relationship between MM and clinicopathological parameters, and 3) determination of LN group where MMs were frequently found. We studied 70 cases of AGC without LN metastasis on initial examination. The tumors were examined for location, size, depth of invasion, differentiation, histologic type, lymphatic invasion, and c-erbB-2 expression. To evaluate MM, pancytokeratin immunohistochemistry was performed in all LNs from 70 cases of AGCs. Among 2,203 dissected LNs from 70 patients, 37 (1.6%) LNs from 19 (27.1%) patients revealed MM. Micrometastases were seen in only group 1 and 2 LNs: none had group 3 and 4 LN involvement. The gender, age, tumor size, location of tumor, histologic type, differentiation, depth of invasion, lymphatic invasion, and c-erbB-2 expression were not significantly associated with MM status. The survival time of the MM-positive group (mean: 62 months) was significantly shorter than that of the MM-negative group (mean: 72 months) (p=0.046). The findings of this study indicate that the presence of MM in LNs is an important prognostic factor in AGC patients.

Case Report

A Case of Gastric Inverted Hyperplastic Polyp Associated with Gastritis Cystica Profunda and Early Gastric Carcinoma.: Min Sung Choi, So Young Jin, Dong Won Kim, Dong Wha Lee, Sang Mo Park; Korean J Pathol. 2007;41(1):55-58.

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Abstract PDF: A gastric inverted hyperplastic polyp is characterized by downward growth of the hyperplastic mucosal components into the submucosa. Lesions are composed of hyperplastic foveolar-type glands, and sometimes coexist with gastritis cystica profunda (GCP). Adenocarcinoma frequen- tly can coexist, but the relationship is not clear. A 71-year-old male was admitted to hospital because of dyspepsia for one month. He underwent a wedge resection of the stomach, after endoscopic biopsies. The gross finding showed a slightly elevated papillary lesion with central depression. Microscopically, the elevated lesion was composed of hyperplastic fundic glands and foveolar cells, and the central depressed lesion showed a nodular inverted proliferation of normal appearing gastric epithelium and glands in the submucosa. An additional proximal gastrectomy specimen exhibited marked GCP and a minute adenocarcinoma at the proximal margin with p53 protein overexpression.

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