Characterization of the Mucin Phenotype Can Predict Gastric Cancer Recurrence After Endoscopic Mucosal Resection

Abstract

-Background -Endoscopic mucosal resection is still considered an accepted treatment for early gastric cancer for selected cases. Histopathologic criteria for curative endoscopic resection are intramucosal well-differentiated adenocarcinoma, lateral and deep margins free of tumor, no histological ulceration, and no venous or lymphatic embolism. A 5% local recurrence rate has been described even when all the above-mentioned criteria are met. On the other hand, antigen expression by tumoral cells has been related to the biological behavior of several tumors. Objective -To evaluate whether early gastric cancer mucin immunoexpression, p53 and Ki-67, can predict recurrence after endoscopic mucosal resection, even when standard histopathologic criteria for curative measures have been attempted. Methods -Twenty-two patients with early gastric cancer were considered to have been completely resected by endoscopic mucosal resection. Local recurrence occurred in 5/22 (22.7%). Immunohistochemical study was possible in 18 (81.8%) resected specimens. Patients were divided in two groups: those with and those without local recurrence. They were compared across demographic, endoscopic, histologic data, and immunohistochemical factors for MUC2, MUC5a, CD10, p53, and Ki-67. Results -Mucin immunoexpression allowed a reclassification of gastric adenocarcinoma in intestinal (10), gastric (2), mixed (4), and null phenotypes (2). Mixed phenotype (positive for both MUC2 and MUC5a) was found in 80% of cases in the local recurrence group, while the intestinal type (positive MUC2 and negative MUC5a) was found in 76.9% of cases without local recurrence (P=0.004). Other observed features did not correlate with neoplastic recurrence. Conclusion -The mixed phenotype of early gastric adenocarcinoma is associated with a higher probability of local recurrence after endoscopic mucosal resection.HEADINGS -Stomach neoplasms. Endoscopic mucosal resection. Gastric mucins.

Phenotype characteristics of gastric epithelial mucus in patients with different gastric diseases: from superficial gastritis to gastric cancer

“…That is to say, the progression of gastric precancerous lesions to GC is a slow and gradual development process, at least targeted monitoring can be performed by mucin typing, and there is an opportunity to detect and remove tumorous lesions early. Although there are currently no clinically deterministic predictive biomarkers in clinical use, the use of mucin staining for subtype analysis can further stratify people who are already at risk (Hondo et al, 2017). In this study, we explored the changes of different mucus phenotypes during the progression of gastric disease.…”

Validation of classic and expanded criteria for endoscopic submucosal dissection of early gastric cancer: 7 years of experience in a Western tertiary cancer center

“…Previous findings from our group corroborate the present results 23 . It is possible that a refinement of the expanded criteria with mucin expression characterization may increase the accuracy of selecting the appropriate patients for ESD 24 .…”

Long non-coding RNAs involved in metastasis of gastric cancer

“…Given that patients are usually asymptomatic and that relapsed GC patients have poor prognosis, many doctors recognize the importance of surveillance in detecting recurrence[ 78 ]. Studies have shown that hematogenous metastasis is the most frequent recurrence pattern during the first year following resection[ 79 ], and identification of a simple method to monitor patients, for example, using serum lncRNAs, is a top priority.…”

“…These authors found that according to the 7 th edition of the TNM classification, classification of stage T4b and N0 as stage IIIA had statistical significance in regard to the survival outcome and in predicting prognoses in Chinese GC patients. Given that lymph node and distant metastasis were found to be key factors in the prognosis of GC patients, we identified the lncRNAs that correlated with lymph node, distant metastasis and the TNM stage, as shown in Table 1 [ 14 - 17 , 23 , 25 - 30 , 32 , 33 , 35 , 36 , 40 , 43 , 44 , 53 , 57 , 58 , 69 , 74 - 78 , 80 - 132 ].…”