Are Borrmann’s Types of Advanced Gastric Cancer Distinct Clinicopathological and Molecular Entities? A Western Study

Abstract

Most studies on the clinicopathological impact of Borrmann classification for gastric cancer (GC) have been performed in Asian patients with type IV tumors, and immunohistochemical features of Borrmann types have scarcely been analyzed. We assessed the clinicopathological, molecular features and prognostic value of Borrmann types in all patients with advanced GC resected in a Western institution (n = 260). We observed a significant relationship between Borrmann types and age, systemic symptoms, tumor size, Laurén subtype, presence of signet-ring cells, infiltrative growth, high grade, tumor necrosis, HERCEPTEST positivity, microsatellite instability (MSI) and molecular subtypes. Polypoid GC showed systemic symptoms, intestinal-type histology, low grade, expansive growth and HERCEPTEST positivity. Fungating GC occurred in symptomatic older patients. It presented intestinal-type histology, infiltrative growth and necrosis. Ulcerated GC showed smaller size, intestinal-type histology, high grade and infiltrative growth. Most polypoid and ulcerated tumors were stable-p53-not overexpressed or microsatellite unstable. Flat lesions were high-grade diffuse tumors with no MSI, and occurred in younger and less symptomatic patients. No association was found between Borrmann classification and prognosis. According to our results, Borrmann types may represent distinct clinicopathological and biological entities. Further research should be conducted to confirm the role of Borrmann classification in the stratification of patients with advanced GC.

Spectral CT for preoperative prediction of lymphovascular invasion in resectable gastric cancer: With external prospective validation

“…Besides, we found CT based Borrmann classification was significant in multivariable analysis and contained in model construction. Borrmann classification descripts tumor aggressiveness by tumor size, infiltration scale and the presence of ulceration, which represents distinct biological entities and reflect tumor aggressiveness ( 22 ). A preliminary work ( 21 ) proved Borrmann classification was an independent risk factor for LNM in GC, thus, we continued to analyze Borrmann classification in this study and found it is an independent predictor for LVI.…”

“…Because tumor thickness was proved to be a risk factor for LNM in a prior study ( 21 ), it was included in this present study continuously, defined as the maximal diameter perpendicular to the longest axis on the maximal cross-section. Borrmann classification on CT was evaluated according to tumor morphology, infiltration scale and presence of ulceration ( 21 , 22 ). Circumscribed mass as classification I, circumscribed mass presented with ulcers as II, infiltrative mass with ulcers as III, and diffuse infiltrative mass as IV ( 16 ).…”

Naples Prognostic Score Predicts Tumor Regression Grade in Resectable Gastric Cancer Treated with Preoperative Chemotherapy

“…Overall, 59 patients underwent surgery. Macroscopic type was assessed by Borrmann classification [ 35 ]. Lauren’s classification was used to define the histological type dividing intestinal from diffuse/mixed tumors [ 36 , 37 ].…”

CDX2 and Ki-67 Expression in Gastric Carcinoma and Its Association with Clinocopathological Parameters

“…At the same time when the gross appearance was correlated with Ki-67, maximum cases (90%) expressed low Ki-67 in all growth pattern types. [12,13].…”