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01-04-2022 | Epstein-Barr Virus | Original Article

Dedifferentiation-like tubular and solid carcinoma of the stomach shows phenotypic divergence and association with deficient SWI/SNF complex

Authors: Shih-Chiang Huang, Kuang-Hua Chen, Kwai-Fong Ng, I-Chieh Lin, Yi-Chun Chao, Ta-Sen Yeh, Huei-Chieh Chuang, Tse-Ching Chen

Published in: Virchows Archiv | Issue 4/2022

Abstract

Gastric carcinoma showing an abrupt transition from a tubular to solid pattern is an unusual phenomenon reminiscent of dedifferentiation. The phenotypic and molecular characteristics of this transition are still unclear. We retrospectively collected 41 gastric carcinomas exhibiting dedifferentiation-like tubular to solid transition and applied an array of immunohistochemical stains, including neuroendocrine and hepatocytic markers, to delineate their lineage. The status of Epstein-Barr virus (EBV) infections, mismatch repair proteins, SWI/SNF complex proteins and p53 expression levels were examined. The clinicopathologic differences were assessed by statistical analysis. Except for 10 cases with neuroendocrine differentiation and 2 EBV-associated carcinomas, we identified 8 hepatoid carcinomas and 21 solid adenocarcinomas with loss of CDX2 and/or hep-par1 expression in solid part (12/29). A subset of solid adenocarcinoma was associated with MSI (8) and mutant p53 expression was frequent in non-MSI cases (10/13). We found hepatoid carcinomas usually harbored SMARCA2 loss (5/8), MSI-associated cases commonly had ARID1A loss (6/8), and non-MSI solid adenocarcinomas frequently showed SMARCA2/A4 loss (7/13) with a high rate of concurrent ARID1A loss (4/7). Spatial correlation between solid transition and loss of SWI/SNF complex subunits were seen in 63% of tumors (12/19). Dedifferentiation-like tubular and solid carcinoma was associated with a propensity to inferior survival outcomes (p = 0.034), especially hepatoid carcinoma and in the non-MSI/EBV intestinal subgroup. In conclusion, gastric cancer exhibiting dedifferentiation-like tubular to solid transition is a phenotypically divergent group that shares common alterations in the SWI/SNF complex.

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Title: Dedifferentiation-like tubular and solid carcinoma of the stomach shows phenotypic divergence and association with deficient SWI/SNF complex
Authors: Shih-Chiang Huang
Kuang-Hua Chen
Kwai-Fong Ng
I-Chieh Lin
Yi-Chun Chao
Ta-Sen Yeh
Huei-Chieh Chuang
Tse-Ching Chen
Publication date: 01-04-2022
Publisher: Springer Berlin Heidelberg
Keywords: Epstein-Barr Virus
Gastric Cancer
Gastric Cancer
Published in: Virchows Archiv / Issue 4/2022
Print ISSN: 0945-6317
Electronic ISSN: 1432-2307
DOI: https://doi.org/10.1007/s00428-022-03288-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Dedifferentiation-like tubular and solid carcinoma of the stomach shows phenotypic divergence and association with deficient SWI/SNF complex

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

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