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Published in: BMC Gastroenterology 1/2023

Open Access 01-12-2023 | Endoscopy | Research

Comparison of clinical and pathological features between early-stage gastric-type and intestinal-type differentiated adenocarcinoma: a retrospective study

Authors: Borui Li, Tingting Chen, Dingbao Liang, Yin Zhang, Xiwei Ding, Ying Lv

Published in: BMC Gastroenterology | Issue 1/2023

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Abstract

Background

The clinicopathological features and endoscopic characteristics under magnifying endoscopy with narrow band imaging (ME-NBI) between early-stage gastric-type differentiated adenocarcinoma (GDA) and intestinal-type differentiated adenocarcinoma (IDA) remain controversial.

Methods

Early gastric adenocarcinomas that underwent endoscopic submucosal dissection (ESD) in Nanjing Drum Tower Hospital between August 2017 and August 2021 were included in the present study. GDA cases and IDA cases were selected based on morphology and immunohistochemistry staining of CD10, MUC2, MUC5AC, and MUC6. Clinicopathological data and endoscopic findings in ME-NBI were compared between GDAs and IDAs.

Results

The mucin phenotypes of 657 gastric cancers were gastric (n = 307), intestinal (n = 109), mixed (n = 181) and unclassified (n = 60). No significant difference was observed in terms of gender, age, tumor size, gross type, tumor location, background mucosa, lymphatic invasion, and vascular invasion between patients with GDA and IDA. GDA cases were associated with deeper invasion than IDA cases (p = 0.007). In ME-NBI, GDAs were more likely to exhibit an intralobular loop patten, whereas IDAs were more likely to exhibit a fine network pattern. In addition, the proportion of none-curative resection in GDAs was significantly higher than that in IDAs (p = 0.007).

Conclusion

The mucin phenotype of differentiated early gastric adenocarcinoma has clinical significance. GDA was associated with less endoscopically resectability than IDA.
Literature
1.
go back to reference Lauren P. The two histological main types of gastric carcinoma: diffuse and so-called intestinal-type carcinoma. an attempt at a histo-clinical classification. Acta Pathol Microbiol Scand. 1965;64:31–49. Lauren P. The two histological main types of gastric carcinoma: diffuse and so-called intestinal-type carcinoma. an attempt at a histo-clinical classification. Acta Pathol Microbiol Scand. 1965;64:31–49.
2.
go back to reference Nakamura K, Sugano H, Takagi K. Carcinoma of the stomach in incipient phase: its histogenesis and histological appearances. Gan. 1968;59:251–8.PubMed Nakamura K, Sugano H, Takagi K. Carcinoma of the stomach in incipient phase: its histogenesis and histological appearances. Gan. 1968;59:251–8.PubMed
3.
go back to reference Japanese Gastric Cancer A. Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer. 2011;14:101–12. Japanese Gastric Cancer A. Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer. 2011;14:101–12.
4.
go back to reference Yonezawa S, Higashi M, Yamada N, et al. Mucins in human neoplasms: clinical pathology, gene expression and diagnostic application. Pathol Int. 2011;61:697–716.CrossRefPubMed Yonezawa S, Higashi M, Yamada N, et al. Mucins in human neoplasms: clinical pathology, gene expression and diagnostic application. Pathol Int. 2011;61:697–716.CrossRefPubMed
5.
go back to reference Koseki K, Takizawa T, Koike M, et al. Distinction of differentiated type early gastric carcinoma with gastric type mucin expression. Cancer. 2000;89:724–32.CrossRefPubMed Koseki K, Takizawa T, Koike M, et al. Distinction of differentiated type early gastric carcinoma with gastric type mucin expression. Cancer. 2000;89:724–32.CrossRefPubMed
6.
go back to reference Saito A, Shimoda T, Nakanishi Y, et al. Histologic heterogeneity and mucin phenotypic expression in early gastric cancer. Pathol Int. 2001;51:165–71.CrossRefPubMed Saito A, Shimoda T, Nakanishi Y, et al. Histologic heterogeneity and mucin phenotypic expression in early gastric cancer. Pathol Int. 2001;51:165–71.CrossRefPubMed
7.
go back to reference Valente P, Garrido M, Gullo I, et al. Epithelial dysplasia of the stomach with gastric immunophenotype shows features of biological aggressiveness. Gastric Cancer. 2015;18:720–8.CrossRefPubMed Valente P, Garrido M, Gullo I, et al. Epithelial dysplasia of the stomach with gastric immunophenotype shows features of biological aggressiveness. Gastric Cancer. 2015;18:720–8.CrossRefPubMed
8.
go back to reference Kim DH, Shin N, Kim GH, et al. Mucin expression in gastric cancer: reappraisal of its clinicopathologic and prognostic significance. Arch Pathol Lab Med. 2013;137:1047–53.CrossRefPubMed Kim DH, Shin N, Kim GH, et al. Mucin expression in gastric cancer: reappraisal of its clinicopathologic and prognostic significance. Arch Pathol Lab Med. 2013;137:1047–53.CrossRefPubMed
9.
go back to reference Yokoyama A, Inoue H, Minami H, et al. Novel narrow-band imaging magnifying endoscopic classification for early gastric cancer. Dig Liver Dis. 2010;42:704–8.CrossRefPubMed Yokoyama A, Inoue H, Minami H, et al. Novel narrow-band imaging magnifying endoscopic classification for early gastric cancer. Dig Liver Dis. 2010;42:704–8.CrossRefPubMed
10.
go back to reference Nakayoshi T, Tajiri H, Matsuda K, et al. Magnifying endoscopy combined with narrow band imaging system for early gastric cancer: correlation of vascular pattern with histopathology (including video). Endoscopy. 2004;36:1080–4.CrossRefPubMed Nakayoshi T, Tajiri H, Matsuda K, et al. Magnifying endoscopy combined with narrow band imaging system for early gastric cancer: correlation of vascular pattern with histopathology (including video). Endoscopy. 2004;36:1080–4.CrossRefPubMed
11.
go back to reference Yagi K, Nakamura A, Sekine A, et al. Magnifying Endoscopy with Narrow Band Imaging for Early Differentiated Gastric Adenocarcinoma. Dig Endosc. 2008;20:115–22.CrossRef Yagi K, Nakamura A, Sekine A, et al. Magnifying Endoscopy with Narrow Band Imaging for Early Differentiated Gastric Adenocarcinoma. Dig Endosc. 2008;20:115–22.CrossRef
12.
go back to reference Ok KS, Kim GH, Park do Y, et al. Magnifying Endoscopy with Narrow Band Imaging of Early Gastric Cancer: Correlation with Histopathology and Mucin Phenotype. Gut Liver. 2016;10:532–41. Ok KS, Kim GH, Park do Y, et al. Magnifying Endoscopy with Narrow Band Imaging of Early Gastric Cancer: Correlation with Histopathology and Mucin Phenotype. Gut Liver. 2016;10:532–41.
13.
go back to reference Kobayashi M, Takeuchi M, Ajioka Y, et al. Mucin phenotype and narrow-band imaging with magnifying endoscopy for differentiated-type mucosal gastric cancer. J Gastroenterol. 2011;46:1064–70.CrossRefPubMed Kobayashi M, Takeuchi M, Ajioka Y, et al. Mucin phenotype and narrow-band imaging with magnifying endoscopy for differentiated-type mucosal gastric cancer. J Gastroenterol. 2011;46:1064–70.CrossRefPubMed
14.
go back to reference Kimiyasu Y, Yusuke T, Tsutomu K, et al. Tumor differentiation phenotype in gastric differentiated-type tumors and its relation to tumor invasion and genetic alterations. World J Gastroenterol. 2006;12:3803–9.CrossRef Kimiyasu Y, Yusuke T, Tsutomu K, et al. Tumor differentiation phenotype in gastric differentiated-type tumors and its relation to tumor invasion and genetic alterations. World J Gastroenterol. 2006;12:3803–9.CrossRef
15.
go back to reference Oue N, Sentani K, Sakamoto N, et al. Clinicopathologic and molecular characteristics of gastric cancer showing gastric and intestinal mucin phenotype. Cancer Sci. 2015;106:951–8.CrossRefPubMedPubMedCentral Oue N, Sentani K, Sakamoto N, et al. Clinicopathologic and molecular characteristics of gastric cancer showing gastric and intestinal mucin phenotype. Cancer Sci. 2015;106:951–8.CrossRefPubMedPubMedCentral
17.
go back to reference Hiroya U, Takashi Y, Yutaka N, et al. Gastric Adenocarcinoma of Fundic Gland Type (Chief Cell Predominant Type): Proposal for a New Entity of Gastric Adenocarcinoma. Am J Surg Pathol. 2010;34:609–19.CrossRef Hiroya U, Takashi Y, Yutaka N, et al. Gastric Adenocarcinoma of Fundic Gland Type (Chief Cell Predominant Type): Proposal for a New Entity of Gastric Adenocarcinoma. Am J Surg Pathol. 2010;34:609–19.CrossRef
18.
go back to reference Ha Kim G, Am Song G, Youn Park D, et al. CDX2 expression is increased in gastric cancers with less invasiveness and intestinal mucin phenotype. Scand J Gastroenterol. 2006;41:880–6.CrossRefPubMed Ha Kim G, Am Song G, Youn Park D, et al. CDX2 expression is increased in gastric cancers with less invasiveness and intestinal mucin phenotype. Scand J Gastroenterol. 2006;41:880–6.CrossRefPubMed
19.
go back to reference Kitaichi T, Dohi O, Fujita Y, et al. Clinical and Pathological Challenges in the Diagnosis of Gastric-Type Differentiated Adenocarcinoma in the Stomach: A Study of Endoscopic Submucosal Dissection Cases. Digestion. 2019;99:301–9.CrossRefPubMed Kitaichi T, Dohi O, Fujita Y, et al. Clinical and Pathological Challenges in the Diagnosis of Gastric-Type Differentiated Adenocarcinoma in the Stomach: A Study of Endoscopic Submucosal Dissection Cases. Digestion. 2019;99:301–9.CrossRefPubMed
20.
go back to reference Takami H, Sentani K, Matsuda M, et al. Cytokeratin expression profiling in gastric carcinoma: clinicopathologic significance and comparison with tumor-associated molecules. Pathobiology. 2012;79:154–61.CrossRefPubMed Takami H, Sentani K, Matsuda M, et al. Cytokeratin expression profiling in gastric carcinoma: clinicopathologic significance and comparison with tumor-associated molecules. Pathobiology. 2012;79:154–61.CrossRefPubMed
21.
go back to reference Han HS, Lee SY, Lee KY, et al. Unclassified mucin phenotype of gastric adenocarcinoma exhibits the highest invasiveness. J Gastroenterol Hepatol. 2009;24:658–66.CrossRefPubMed Han HS, Lee SY, Lee KY, et al. Unclassified mucin phenotype of gastric adenocarcinoma exhibits the highest invasiveness. J Gastroenterol Hepatol. 2009;24:658–66.CrossRefPubMed
22.
go back to reference Machado J, Nogueira A, Carneiro F, et al. Gastric carcinoma exhibits distinct types of cell differentiation: an immunohistochemical study of trefoil peptides (TFF1 and TFF2) and mucins (MUC1, MUC2, MUC5AC, and MUC6). J Pathol. 2000;190:437–43.CrossRefPubMed Machado J, Nogueira A, Carneiro F, et al. Gastric carcinoma exhibits distinct types of cell differentiation: an immunohistochemical study of trefoil peptides (TFF1 and TFF2) and mucins (MUC1, MUC2, MUC5AC, and MUC6). J Pathol. 2000;190:437–43.CrossRefPubMed
23.
go back to reference Jass J. Mucin core proteins as differentiation markers in the gastrointestinal tract. Histopathology. 2000;37:561–4.CrossRefPubMed Jass J. Mucin core proteins as differentiation markers in the gastrointestinal tract. Histopathology. 2000;37:561–4.CrossRefPubMed
24.
go back to reference Cancer JG, A. Japanese Gastric Cancer Treatment Guidelines,. 6th edition. Gastric Cancer. 2021;2023(26):1–25. Cancer JG, A. Japanese Gastric Cancer Treatment Guidelines,. 6th edition. Gastric Cancer. 2021;2023(26):1–25.
25.
go back to reference Hatta W, Gotoda T, Oyama T, et al. A Scoring System to Stratify Curability after Endoscopic Submucosal Dissection for Early Gastric Cancer: “eCura system.” Am J Gastroenterol. 2017;112:874–81.CrossRefPubMed Hatta W, Gotoda T, Oyama T, et al. A Scoring System to Stratify Curability after Endoscopic Submucosal Dissection for Early Gastric Cancer: “eCura system.” Am J Gastroenterol. 2017;112:874–81.CrossRefPubMed
26.
go back to reference Tsukashita S, Kushima R, Bamba M, et al. MUC gene expression and histogenesis of adenocarcinoma of the stomach. Int J Cancer. 2001;94:166–70.CrossRefPubMed Tsukashita S, Kushima R, Bamba M, et al. MUC gene expression and histogenesis of adenocarcinoma of the stomach. Int J Cancer. 2001;94:166–70.CrossRefPubMed
27.
go back to reference Horiuchi Y, Fujisaki J, Yamamoto N, et al. Undifferentiated-type component mixed with differentiated-type early gastric cancer is a significant risk factor for endoscopic non-curative resection. Dig Endosc. 2018;30:624–32.CrossRefPubMed Horiuchi Y, Fujisaki J, Yamamoto N, et al. Undifferentiated-type component mixed with differentiated-type early gastric cancer is a significant risk factor for endoscopic non-curative resection. Dig Endosc. 2018;30:624–32.CrossRefPubMed
28.
go back to reference Seo HS, Lee GE, Kang MG, et al. Mixed Histology Is a Risk Factor for Lymph Node Metastasis in Early Gastric Cancer. J Surg Res. 2019;236:271–7.CrossRefPubMed Seo HS, Lee GE, Kang MG, et al. Mixed Histology Is a Risk Factor for Lymph Node Metastasis in Early Gastric Cancer. J Surg Res. 2019;236:271–7.CrossRefPubMed
29.
go back to reference Song K, Yang Q, Yan Y, et al. Gastric mucin phenotype indicates aggressive biological behaviour in early differentiated gastric adenocarcinomas following endoscopic treatment. Diagn Pathol. 2021;16:62.CrossRefPubMedPubMedCentral Song K, Yang Q, Yan Y, et al. Gastric mucin phenotype indicates aggressive biological behaviour in early differentiated gastric adenocarcinomas following endoscopic treatment. Diagn Pathol. 2021;16:62.CrossRefPubMedPubMedCentral
30.
go back to reference Nakamura T, Yao T, Kakeji Y, et al. Depressed type of intramucosal differentiated-type gastric cancer has high cell proliferation and reduced apoptosis compared with the elevated type. Gastric Cancer. 2013;16:94–9.CrossRefPubMed Nakamura T, Yao T, Kakeji Y, et al. Depressed type of intramucosal differentiated-type gastric cancer has high cell proliferation and reduced apoptosis compared with the elevated type. Gastric Cancer. 2013;16:94–9.CrossRefPubMed
Metadata
Title
Comparison of clinical and pathological features between early-stage gastric-type and intestinal-type differentiated adenocarcinoma: a retrospective study
Authors
Borui Li
Tingting Chen
Dingbao Liang
Yin Zhang
Xiwei Ding
Ying Lv
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Gastroenterology / Issue 1/2023
Electronic ISSN: 1471-230X
DOI
https://doi.org/10.1186/s12876-023-02733-3

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