Precise investigation of 4 cases of adenocarcinoma of the stomach preoperatively undiagnosed by repeated biopsy under endoscopy

Abstract

Background: We often have lesions that can't be diagnosed as adenocarcinoma of the stomach by repeated biopsy under endoscopy. Recently histochemical and immunohistochemical analyses of mucin of stomach have advanced. We report 4 cases which couldn't be diagnosed as adenocarcinomas of the stomach by repeated biopsy preoperatively, but resulted in advanced adenocarcinomas histologically. We performed mucin histochemical and immunohistochemical analyses on them. Methods: We had four intriguing adenocarcinomas of the stomach. We couldn't diagnose the biopsies as adenocarcinomas by HE Group I(normal or benign). Case 2: 59y.o. female, Borrmann's III, T2N2MO, biopsy; Group I. Case 3: 49y.o. male, Borrmann's III, T3NOMO, biopsy; Group II(atypia but benign) or III(borderline malignancy). Case 4: 62y.o. male, Borrmann's II, T3NOMO, biopsy; Group I. Sections were stained with the following mucin and immunohistochemical methods: galactose oxidase-Schiff (GOS), high-iron diamines-Alcian blue, pH 2.5 (HID-AB),CDIO, Ki-67. Results: The phenotype of the 4 cases are shown above (Table 1). Conclusion: Characters of mucin of these adenocarcinomas are distinct from those of surrownding normal mucosa, which helps diagnosing pathologically confusing adenocarcinoma of the stomach. These results suggest that mucin staining can be used in co-diagnosis with endoscopic findings for adenocarcinoma of the stomach before operation. 6374