Abstract
BackgroundThe distribution of mucin phenotypes and their relationship with clinicopathological features in early differentiated gastric adenocarcinomas in a Chinese cohort are unknown. We aimed to investigate mucin phenotypes and analyse the relationship between mucin phenotypes and clinicopathological features, especially biological behaviours, in early differentiated gastric adenocarcinomas from endoscopic specimens in a Chinese cohort.MethodsImmunohistochemical staining of CD10, MUC2, MUC5AC, and MUC6 was performed in 257 tissue samples from patients with early differentiated gastric adenocarcinomas. The tumour location, gross type, tumour size, histological type, depth of invasion, lymphovascular invasion, mucosal background and other clinicopathological parameters were evaluated. The relationship between mucin phenotypes and clinicopathological features was analysed with the chi-square test.ResultsThe incidences of gastric, gastrointestinal, intestinal and null phenotypes were 21 %, 56 %, 20 and 3 %, respectively. The mucin phenotypes were related to histology classification (P < 0.05). The proportion of the gastric phenotype became greater during the transition from differentiated to undifferentiated (P < 0.05). Complete intestinal metaplasia was higher in the gastric and intestinal phenotypes than in the gastrointestinal phenotype (P < 0.05). Tumours with poorly differentiated adenocarcinoma were mainly of the gastric phenotype, which was significantly higher than that of purely differentiated tubular adenocarcinoma (P < 0.05), and the depth of invasion in the mixed type was deeper (P < 0.05). Neither recurrence nor metastasis was detected.ConclusionsThe mucin phenotype of early-differentiated gastric adenocarcinoma has clinical implications, and the gastric phenotype has aggressive biological behaviour in early differentiated gastric cancers, especially in those with poorly differentiated adenocarcinoma or papillary adenocarcinoma components.
Highlights
The distribution of mucin phenotypes and their relationship with clinicopathological features in early differentiated gastric adenocarcinomas in a Chinese cohort are unknown
Expression of mucin markers and mucin phenotype in early gastric cancers The expression percentages of CD10, MUC2, MUC5AC and MUC6 in all Early gastric cancer (EGC) were 43.58 % (112/257), 63.81 % (164/257), 64.98 % (167/257) and 72.76 % (187/257) respectively (Fig. 1)
Two hundred fifty-seven EGCs were classified as Gtype (21 %, 54/257), gastrointestinal phenotype (GI-type) (56 %, 144/257), intestinal phenotype (I-type) (20 %, 51/257) and null phenotype (N-type) (3 %, 8/257)
Summary
The distribution of mucin phenotypes and their relationship with clinicopathological features in early differentiated gastric adenocarcinomas in a Chinese cohort are unknown. Gastric cancer (GC), one of the most common human cancers worldwide, is a disease with multiple pathogenic factors, various prognoses and different responses to treatments. Properly distinguishing those with worse prognoses from those with better prognoses appears to be significantly important. The differentiated type contains pap, tub, and tub according to the JGCA classification and papillary and well/moderately differentiated adenocarcinoma according to the WHO classification. These different histological types exhibit distinct biological behaviours
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