Research on the Histological Features and Pathological Types of Gastric Adenocarcinoma With Mucinous Differentiation.

Nian-Long Meng,Jun-Ling Zhou,Su-Nan Wang,Yang-Kun Wang,Hai-Li Wang

doi:10.3389/fmed.2022.829702

Nian-Long Meng, Jun-Ling Zhou + Show 3 more

Open Access

https://doi.org/10.3389/fmed.2022.829702

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Abstract

ObjectiveTo discuss the histological features, pathological types, and prognosis of gastric adenocarcinoma with mucinous differentiation.MethodsSpecimens of 189 cases of gastric adenocarcinoma with mucinous differentiation were collected for detailed histomorphology, immunohistochemistry, fluorescence in situ hybridization, and follow-up.ResultsIn accordance with the morphological and histological structural features of the cancer cells as well as the area ratio of the mucus, gastric adenocarcinoma with mucinous differentiation was divided into four types, namely pure mucinous carcinoma, intraductal papillary mucinous carcinoma, signet ring cell type mucinous carcinoma, and mixed cell type mucinous carcinoma. Based on the macroscopic types according to Bormann's classification, pure mucinous carcinoma was mostly Type I, intraductal papillary mucinous carcinoma was mostly Type II, signet ring cell type mucinous carcinoma was mostly Type IV, and mixed cell type mucinous carcinoma was mostly Type III. The 5-year survival rate was 69.2, 64.2, 0, and 31.5%, respectively. There was a statistical difference in the lymph node metastasis rate and survival rate of the four carcinoma types. The invasion features of pure mucinous carcinoma entailed penetrating corrosively in a push-in form, without blood vessel or lymphatic metastasis and with few lymphocytes and lymphatic nodules in the marginal area. Thus, there was little lymph node metastasis and invasion of nerves. The HER2 protein expression rate was 40.2% (76/189), the HER2 gene amplification detected by FISH technology was 16.9% (32/189).ConclusionThe independent histological type, four subtypes, and histopathological classification of gastric mucinous adenocarcinoma are important for the prognosis evaluation and precise treatment of this disease.

Highlights

A gastric neoplasm is a highly heterogeneous tumor, as reflected throughout its occurrence, recurrence, and metastasis, from the tumor’s histological morphology, immunophenotype, and DNA ploidy to its molecular biology and genetics [1–4]
In accordance with the morphological and histological structural features of the cancer cells as well as the area ratio of the mucus, gastric adenocarcinoma with mucinous differentiation was divided into four types, namely pure mucinous carcinoma, intraductal papillary mucinous carcinoma, signet ring cell type mucinous carcinoma, and mixed cell type mucinous carcinoma
The independent histological type, four subtypes, and histopathological classification of gastric mucinous adenocarcinoma are important for the prognosis evaluation and precise treatment of this disease

Summary

Introduction

A gastric neoplasm is a highly heterogeneous tumor, as reflected throughout its occurrence, recurrence, and metastasis, from the tumor’s histological morphology, immunophenotype, and DNA ploidy to its molecular biology and genetics [1–4]. Gastric mucinous adenocarcinoma is a type of common gastric cancer, with a WHO International Classification of Disease for Oncology code of 8,480/3 [10–12]. It is usually accompanied by tubular adenocarcinoma, papillary adenocarcinoma, or signet ring cell carcinoma tissues. The prognosis of mucinous carcinoma is poor, especially with widely differentiated signet ring cells [13]. 189 cases of gastric adenocarcinoma with mucinous differentiation have been collected for further research on the morphological features, histopathological type, HER2 gene amplification, and prognosis of the disease to provide a reliable pathological basis for precise clinical treatment

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Conclusion