Metastasis Of Gastric Carcinoma Research Articles

Expression and clinical significance of I-TAC and its receptor CXCR3 in gastric hepatic metastases

Objective To investigate the expression of I-TAC、CXCR3 in gastric cancer, and to reveal the role of I-TAC/CXCR3 in the metastasis of gastric carcinoma. Methods Two groups were selected, the research group (30 gastric cancer tissues with hepatic metastasis), and the control group (35 gastric cancer tissues without liver metastasis). Expression of I-TAC、CXCR3 in surgical specimens were determined by reverse transcription-polymerase chain reaction and immunohistochemistry, respectively. The expression of I-TAC and CXCR3 was detected by immunohistochemical staining in surgical specimens of gastric carcinoma with and without hepatic metastasis. Associations between the above two indicators and clinicopathological characteristics were finally analyzed. Results Compared with those without liver metastasis of gastric cancer tissue, the gene expression of I-TAC and CXCR3 in the gastric carcinoma tissues with hepatic metastasis were significantly higher. Positive expression rate of I-TAC in the gastric tissues with hepatic metastasis were 93.33%%, while positive expression rate of I-TAC in the gastric tissues without hepatic metastasis were 31.43%%, which were significantly lower than that of the group with hepatic metastasis. Positive expression rate of CXCR3 in the research group were 83.33%, while the positive expression rate of CXCR3 in the control group were 45.71%, which were significantly lower than that of the group with hepatic metastasis. Expression of CXCR3 in the tissue of gastric carcinoma were positively related to tissue histologic differentiation, lymph node metastasis. Conclusion Up-regulated expression of I-TAC and CXCR3 was associated with gastric cancer metastasis, I-TAC-CXCR3 signaling pathway may play a role in the process of gastric hepatic metastases. Key words: I-TAC; CXCR3; Chemokine; Gastric hepatic metastases

Application of three-dimensional ultrasonography to assess the abdominal lymph node metastasis of gastric carcinoma

To investigate the clinical value of three-dimensional ultrasonography (3D-US) in the diagnosis of abdominal lymph node metastasis of gastric carcinoma. A total of 95 patients with gastric cancer diagnosed by gastroscopy and confirmed by pathology after operation were examined by 3D-US preoperatively.The characteristics of gastric carcinoma was assessed using QLAB software. The tumor volume, lesion diameter and invasion depth of gastric cancer were measured. All of the 95 subjects were divided into two groups according to their lymph nodes status postoperatively: group N+ , 71 patients with lymph node metastasis; and group N0, 24 patients without lymph node metastasis.The quantitative 3D-US analysis and pathological results of these two groups were compared with each other. The tumor volume of group N+ was significantly higher than that of the group N0 [(26.02±6.87)cm(3) vs. (13.11±2.79)cm(3), P<0.05], the invasion depth was significantly deeper in the group N+ than in the group N0 [(1.57±0.29)cm VS (1.10±0.29)cm, P<0.05]. However, there was no significant difference of the lesion diameters between these two groups. Multivariate analysis showed that tumor volume and depth of invasion are independently correlated with lymph node metastasis. A cut-off value=16.8 cm(3) of the tumor volume for assessing the lymph node metastasis had a sensitivity of 90.1% and specificity of 95.8%, respectively, obtained by the area under the ROC curve. The tumor volume of gastric cancer can be obtained by 3D-ultrasonography, and the tumor volume can be considered as a new potential index to evaluate the abdominal lymph node metastasis of gastric cancer before surgery.

Gastric carcinoma presenting with severe rectal stenosis: ‘Schnitzler’s metastasis’: case report and review of the literature

Distant metastasis of primary gastric carcinoma may occur via venous, lymphatic spread and/or peritoneal seeding. Herein we report on an atypical presentation of clinical, endoscopic, and radiologic features of metastatic gastric adenocarcinoma with symptoms mainly due to rectal carcinomatous involvement. Case report and review of the literature We presented the case of 39-year-old-woman with a clinical history of 6 months of dyspepsia, abdominal discomfort, and constipation, who was admitted to hospital with a full-blown picture of mechanical bowel obstruction. These symptoms occurred owing to secondary linitis plastica of the rectum. An extended Hartmann procedure was performed, and the patient was referred to systemic chemotherapy. The overall survival was 5.5 months. The symptoms, findings, preoperative management, and treatment choices are discussed with a review of published cases of Schintzler’s metastasis. Gastric linitis plastica is the most common cause of secondary neoplastic infiltration of the colon. An unusual case of Schnitzler’s metastasis to the rectum, synchronously or metachronously, should occur from diffuse type signet-ring cell gastric carcinoma. The clinical findings of severe rectal stenosis with a poorly differentiated gastric adenocarcinoma must call attention to the entity of rectal Schnitzler’s metastasis.

Expression and clinical significance of serum response factor and vascular endothelial growth factor receptor 2 in gastric carcinoma

Objective To investigate the expression and clinical significance of serum response factor (SRF) and vascular endothelial growth factor receptor (VEGFR2) in gastric carcinoma. Methods SABC immunohistochemical method was used to determine the expressions of SRF and VEGFR2 in 50 cases of gastric carcinoma, 50 cases of surgery incisal edges and 29 cases of lymph node metastasis focus. Results The detection positive rates of SRF and VEGFR2 in gastric carcinoma were 52.00 % (26/50) and 60.00 % (30/50), respectively, which were significantly higher than those in the normal gastric mucosa [16.00 % (8/50) and 10.00 % (5/50), respectively] (P 0.05), but closely correlated to differentiation degree, invasion depth and lymph node metastasis (P < 0.05). The expressions of SRF and VEGFR2 in the gastric carcinoma were positively correlated (r = 0.594, P < 0.05). Conclusion Overexpressions of SRF and VEGFR2 in gastric carcinoma can be regarded as the poorly prognostic markers and play an important role in invasion and metastasis of gastric carcinoma. Key words: Gastric carcinoma; Serum response factor; Vascular endothelial growth factor receptor 2 Fund program: Science and Technology Support Project of Qinhuangdao (201501B045)

Direct evidence for the involvement of TP53 in the proliferation, migration and invasion of gastric carcinoma cells

Background: Abnormal p53 expression has been observed in gastric carcinoma cells. The question of whether p53 could become a target for gastric carcinoma biological therapy has not yet been determined.Methods: TP53 was silenced by siRNA but overexpressed by vector. RT-PCR measured mRNA expression. Western blot measured protein expression. The CCK-8 method was used to analyze cell proliferation. Cell invasion and migration were analyzed, by a Transwell champer and wound healing assay, respectively.Results: TP53 siRNA significantly silenced TP53 expression and pEGFP-TP53 vector overexpressed p53 protein. Silencing TP53 expression significantly increased cell proliferation, invasion, and migration in BGC-823 cells. In contrast, p53 overexpression significantly inhibited cell proliferation, invasion, and migration in BGC-823 cells.Conclusion: p53 overexpression may prove a useful strategy for targeted inhibition of gastric carcinoma cell growth and metastasis.

Risk of lymph node metastasis in mixed-type early gastric cancer determined by the extent of the poorly differentiated component.

To predict the rate of lymph node (LN) metastasis in diffuse- and mixed-type early gastric cancers (EGC) for guidelines of the treatment. We reviewed 550 cases of EGC with diffuse- and mixed-type histology. We investigated the clinicopathological factors and histopathological components that influence the probability of LN metastasis, including sex, age, site, gross type, presence of ulceration, tumour size, depth of invasion, perineural invasion, lymphovascular invasion, and LN metastasis status. We reviewed all slides and estimated the proportions of each tumour component; pure diffuse type, mixed-predominantly diffuse type (diffuse > intestinal type), mixed-predominantly intestinal type (intestinal > diffuse type), and mixed diffuse = intestinal type. We calculated the extents of the respective components. LN metastasis was observed in 12.9% (71/550) of early gastric cancers cases [15/288 mucosal EGCs (5.2%) and 56/262 submucosal EGCs (21.4%)]. Of 550 cases, 302 were diffuse-type and 248 were mixed-type EGCs. Of 248 mixed-type EGCs, 163 were mixed-predominantly diffuse type, 82 were mixed-predominantly intestinal type, and 3 were mixed diffuse = intestinal type. Mixed-type cases with predominantly diffuse type histology showed a higher frequency of LN metastasis (20.2%) than cases of pure diffuse type (9.3%) and predominantly intestinal type (12.2%) histology. We measured the dimensions of each component (intestinal and diffuse type) to determine the association of the extent of each component with LN metastasis in mixed-type gastric carcinoma. The total tumour size and the extent of poorly differentiated components was associated with LN metastasis, while that of signet ring cell components was not. We recommend careful identification and quantitative evaluation of mixed-type early gastric cancer components after endoscopic resection to determine the intensity of the treatment.

Evaluated possibility of adenocarcinoma diagnostics under the cytological method by the uterine cervix material

The results of cytological diagnostics of 138 patients with adenocarcinoma of the uterine cervix were analyzed. Cytological verification of adenocarcinoma in specimens by the uterine cervix material allowed diagnosing as primary adenocarcinoma of the uterine cervix as well as metastatic lesions. The diagnose adenocarcinoma by the uterine cervix material was occurred in cases of 1) endometrioid carcinoma of 87 (63.0 %) patients; 2) endocervical carcinoma of 21 (15.2 %) patients; 3) metastases of serous ovarian carcinoma in 18 (13.0 %) cases; 4) other metastases-colon carcinoma of 6 (4.4 %) patients, rectal carcinoma 2 (1.4 %), glandular carcinoma including gastric signet ring cell carcinoma 3 (2.3 %), and mucinous carcinoma of unknown organs of 1 (0.7 %) patient. Particular features of the uterine cervix adenocarcinoma, endometrioid carcinoma and ovarian carcinoma due to data of discriminate analysis were not noticed. Metastatic intestinal adenocarcinoma has specific palisade-like cells located in complexes that allowed to verify carcinoma. Also, presence signet ring tumour cells allowed to diagnose the metastasis of gastric signet ring cell carcinoma.

Mixed Carcinoma as an Independent Prognostic Factor in Submucosal Invasive Gastric Carcinoma

Mixed carcinoma shows a mixture of glandular and signet ring/poorly cohesive cellular histological components and the prognostic significance of each component is not fully understood. This study aimed to investigate the significance of the poorly cohesive cellular histological component as a risk factor for lymph node metastasis and to examine the diagnostic reliability of endoscopic biopsy. Clinicopathologic characteristics of 202 patients who underwent submucosal invasive gastric carcinoma resection with lymph node dissection in 2005–2012 were reviewed. Mixed carcinoma accounted for 27.2% (56/202) of cases. The overall prevalence of lymph node metastasis was 17.3% (35/202). Lymphatic invasion (P < 0.001), family history of carcinoma (P = 0.025), tumor size (P = 0.004), Lauren classification (P = 0.042), and presence of any poorly cohesive cellular histological component (P = 0.021) positively correlated with the lymph node metastasis rate on univariate analysis. Multivariate analyses revealed lymphatic invasion, family history of any carcinoma, and the presence of any poorly cohesive cellular histological component to be significant and independent factors related to lymph node metastasis. Review of preoperative biopsy slides showed that preoperative biopsy demonstrated a sensitivity of 63.6% and a specificity of 100% in detecting the presence of the poorly cohesive cellular histological component, compared with gastrectomy specimens. The presence of any poorly cohesive cellular histological component was an independent risk factor associated with lymph node metastasis in submucosal invasive gastric carcinoma. Endoscopic biopsy had limited value in predicting the presence and proportion of the poorly cohesive cellular histologic component due to the heterogeneity of mixed carcinoma.

Relationship of the interaction between age and gene polymorphisms with the susceptibility, invasion and metastasis of gastric carcinoma

Objective To investigate the relationship of the interaction between age and polymorphisms of E-selectin gene A561C, chemokine receptor CCR2 gene A190G with the susceptibility, invasion and metastasis of gastric carcinoma. Methods Based on tumor-node-metastasis (TNM) staging classification, 750 patients with confirmed gastric carcinoma in our hospital from December 2011 to November 2014 were divided into 5 groups: stageⅠ, stage Ⅱ, stage Ⅲ, stage Ⅳ and stage 0 (n=150, each). No significant difference was observed in gender, ethnicity, birthplace and living habits among the 5 groups. Meanwhile, 750 healthy controls were selected in this study during the same time, and there was no significant difference in gender, ethnicity and birthplace between the healthy controls and patients with gastric carcinoma. The genetic polymorphisms of E-selectin gene A561C and chemokine receptor CCR2 gene A190G were analyzed by polymerase chain reaction-restriction fragment length polymorphisms (PCR-RFLP) in peripheral blood mononuclear cells (PBMs). Results The frequencies of CC (A561C) and GG (A190G) genotypes were 56.5% and 56.8% respectively in gastric carcinoma cases and 22.8% and 23.1% respectively in healthy controls, with statistically significant differences in the distribution frequencies between the two groups (P 1 for both). The distribution frequencies of CC (A561C) genotype and GG (190A/G) genotype were 50.0% and 50.0% in stage Ⅰ, 63.4% and 64.0% in stage Ⅱ, 69.3% and 69.3% in stage Ⅲ, 76.7% and 77.3% in stage Ⅳ, and 23.3% and 23.3% in stage 0 respectively. Statistically significant differences were found in the distribution frequencies between stage 0 and the other 4 stages (P 1 for All). Conclusions Age and E-selectin gene A561C (CC) and chemokine receptor CCR2 gene A190G (GG) are the risk factors for the invasion and metastasis of gastric carcinoma, and the interactions between age and genetic polymorphisms increase the risk of invasion and metastasis of gastric carcinoma. Key words: Stomach neoplasms; Neoplasm metastasis; E-selectin; Receptors, chemokine; Polymorphism, restriction fragment length

MicroRNA-1225-5p inhibits proliferation and metastasis of gastric carcinoma through repressing insulin receptor substrate-1 and activation of β-catenin signaling.

Emerging evidence has linked aberrantly expressed microRNAs (miRNAs) with oncogenesis and malignant development in various human cancers. However, their specific roles and functions in gastric carcinoma (GC) remain largely undefined. In this study we identify and report a novel miRNA, miR-1225-5p, as tumor suppressor in GC development and progression. Microarray analysis revealed that there were fifty-six differentially expressed miRNAs (thirty-two upregulated and twenty-four downregulated) in GC tumor samples compared to their corresponding nontumorous tissues. Downregulation of miR-1225-5p was frequently detected in GC and strongly correlated with more aggressive phenotypes and poor prognosis. Functional assays demonstrated that ectopic overexpression of miR-1225-5p could inhibit cell proliferation, colony formation, migration and invasion in vitro, as well as suppress tumor growth and metastasis in nude mice. Further integrative and functional studies suggested insulin receptor substrate 1 (IRS1) as a downstream effector of miR-1225-5p which acted through β-catenin signaling pathway. These results demonstrate that miR-1225-5p serves to constrain GC growth and metastatic potential via inhibition of IRS1 and β-catenin signaling. Therefore, downregulation of miR-1225-5p is likely to be one of major molecular mechanisms accounting for the development and progression of GC.

Significance of MUC1 expression in biopsy specimens of submucosal invasive gastric carcinoma: The association with lymph node metastasis.

Mucin 1, cell surface associated (MUC1) is a tumor-associated glycoprotein that has been reported to have an important role in lymphatic invasion and metastasis. The present study aimed to investigate the significance of MUC1 expression in endoscopic biopsy specimens of submucosal invasive gastric carcinomas and the association with lymph node metastasis. The clinicopathological features of 144 cases of surgically resected submucosal invasive gastric carcinomas and their paired endoscopic biopsy specimens were reviewed. Immunohistochemical staining for MUC1 was performed for the 144 endoscopic biopsy specimens. Positive MUC1 expression was identified in 70 (49%) cases. In addition, univariate analysis revealed that MUC1 expression was significantly associated with the presence of poorly-differentiated (P=0.001) and poorly-cohesive (P=0.015) carcinoma cells, undifferentiated type by Japanese classification (P<0.001), diffuse type of Lauren classification (P<0.001) and lymph node metastasis (P=0.024). By multivariate analysis, diffuse type of Lauren classification (P<0.001) and lymph node metastasis (P=0.035) were identified as independent factors for MUC1 expression. Furthermore, MUC1 expression (P=0.007), tumor size (P=0.018) and lymphatic invasion (P<0.001) were demonstrated to be independent factors for lymph node metastasis under multivariate analysis. In conclusion, the results of the present study indicated that positive MUC1 expression in endoscopic biopsy specimens may be a predictive factor of lymph node metastasis in submucosal invasive gastric carcinoma.

Sentinel lymph node in gastric cancer.

e15014 Background: In the European Union, Portugal is the country with the highest incidence of gastric cancer. The prognostic value of lymph node metastasis in gastric carcinoma was accepted long ...

L-type amino acid transporter 1 (LAT1) expression in lymph node metastasis of gastric carcinoma: Its correlation with size of metastatic lesion and Ki-67 labeling

L-type amino acid transporter 1 (LAT1) is one of the major amino acid transporters. High levels of LAT1 expression have been reported in various tumors, which can act as a novel prognostic marker. Previously, we demonstrated that LAT1 is highly expressed in advanced gastric carcinoma with lymph node metastasis, and proposed that LAT1 is an independent prognostic factor in non-scirrhous gastric carcinoma. The aim of the present study was to investigate the relationship between LAT1 expression and the size of lymph node metastatic lesions in gastric carcinoma. LAT1 and Ki-67 expression was immunohistochemically analyzed in 64 cases of advanced gastric carcinoma with lymph node metastasis. LAT1 expression in the metastatic lymph nodes was correlated with that in the primary lesions. The high LAT1 expression group showed a larger size of metastatic lesion and a higher Ki-67 labeling index than the low LAT1 expression group. LAT1 expression had a weak association with Ki-67 labeling index and tumor diameter of lymph nodes. These results suggest that LAT1 expression is associated with disease progression in gastric carcinoma. We proposed that LAT1 could be a potential therapeutic target for gastric carcinoma cases with large lymph node metastasis.

Cellular and molecular mechanisms of perineural Invasion in gastric cancer

Perineural invasion(PNI) is one of the important routes for metastasis of gastric carcinoma and results in local recurrence and cancer pain after radical gastrectomy. The dismal prognosis of gastric cancer has been intimately associated with lymph node metastasis, hematogenous metastasis that partly caused by PNI. Nerve, vascular and lymphatic constitutes the tumor microenvironment which plays a decisive role in the development of cancer. Molecular interaction and morphological change contribute to reciprocal signaling interactions between tumor cell and nerve. However, the underlying mechanism of PNI in gastric cancer is still unclear and needs further study. Here, we present a brief review of literatures on the topic of PNI in gastric cancer.

The clinical significance and risk factors of solitary lymph node metastasis in gastric cancer.

AimsTo assess the clinical significance and risk factors of solitary lymph node metastasis (SLM) in gastric carcinoma and establish a more accurate method to evaluate the possibility of lymph node metastasis (LM).MethodsA total of 385 patients with gastric carcinoma who underwent D2 lymphadenectomy at the Cancer Center of Sun Yat-Sen University were included in this research. Then we used a group of data from Sun Yat-sen University Gastrointestinal Hospital (SYSUGIH) to validate the accuracy of our developed method. The χ2 test, Kaplan–Meier analysis, log-rank test, COX model, and discriminate analysis were used to analyze the data with SPSS13.0.ResultsWe found that the LM number and pathological T staging were independent prognostic risk factors. CEA grading, LN status by CT, and T staging by CT were independent risk factors for LM in gastric carcinoma. In addition, we developed the equation Y = -5.0 + X 1 + 1.8X 3 + 0.7X 4 (X 1 = CEA grading, X 3 = LN status by CT, X 4 = T staging by CT) to evaluate the situation of LM. The data from SYSUGIH shows this equation has a better accuracy compared with CT.ConclusionsSLM is an independent risk factor in gastric cancer. And there was no survival difference between the skip metastasis group and the other SLM group (P = 0.659). It is inappropriate for the patient with SLM doing a standard D2 lymphadenectomy, due to the fact that LM rarely occurs in the splenic artery, splenic hilum. The risk factors for LM include CEA grading, LN status by CT, and T staging by CT. And we can use Y = -5.0 + X 1 + 1.8X 3 + 0.7X 4 (X 1, CEA grading, X 3 = LN status by CT, X 4 = T staging by CT, the critical value is 0.3) to estimate the possibility of LM, which has a better accuracy compared with CT.

Metastasis of Gastric Signet-Ring Cell Carcinoma to the Urinary Bladder: A Case Report and Review of the Literature.

Although signet-ring cell (SRC) adenocarcinoma is commonly seen in the stomach, it is a very rarely seen histologic entity in the bladder. It is difficult to distinguish primary SRC adenocarcinoma of the bladder from bladder metastasis of SRC carcinoma of the stomach only based on histological findings. In such cases, clinical findings and immunohistochemical studies may be helpful. We present here a 48-year-old male patient presenting with hematuria and abdominal pain. Computerised tomography of the patient revealed a gastric mass, peritoneal involvement, and thickening of the bladder wall, and histopathological analysis revealed SRC adenocarcinoma in both of the endoscopic biopsies taken from the stomach and bladder. Immunohistochemical analyses confirmed the diagnosis of SRC adenocarcinoma of the bladder secondary to gastric cancer.

Association of hyperlipidemia with lymph node metastasis in early gastric carcinoma

Background: The aim of this study was to see association between pre-operative serum lipid profile and the nodal status of early gastric carcinoma. Methods: It was a retrospective study. Seventy newly diagnosed patients of early gastric carcinoma admitted in the department of general surgery in a tertiary care teaching hospital over a duration of two years, were included in the study. Fasting serum level of total cholesterol and triglyceride were estimated in patients who were proven to have early gastric carcinoma on histopathological examination (HPE). Results: Forty six (65.71%) patients had deranged lipid profile. Of these 38 were males and 8 were females. The study showed that 17 male patients had lipid levels in normal range and of these 10 (58.82%) patients had lymph node involvement; while remaining 7 (41.18%) did not have lymph node involvement. Remaining 38 male patients had elevated lipid levels of whom 30 (78.95%) patients had lymph node involvement, while remaining 8 patients did not have lymph node involvement. Eight female patients had elevated lipid levels and suffered from gastric carcinoma, of which 5 (62.5%) had lymph node involvement and rest 3 (37.5%) had no lymph node involvement. Conclusions: Deranged serum lipid levels favour the development of lymph node metastasis in patients with early gastric carcinoma.

Correlation between microsatellite instability-high phenotype and occult lymph node metastasis in gastric carcinoma.

The aim of this study is to investigate the association of microsatellite instability (MSI) status with nodal status in gastric carcinoma (GC). MSI status was investigated in 623 consecutively resected GCs. To detect occult lymph node (LN) metastasis, immunohistochemistry (IHC) using antibodies against pan-cytokeratin was performed in 391 node-negative cases by initial histologic examination. MSI-high (MSI-H) phenotype was found in 68 GC cases (10.9%) and was significantly associated with increased patient age, antral location, intestinal type, absence of venous/perineural invasion, and expanding growth type (p<0.05). When the nodal status was evaluated, the number of metastatic LNs of MSI-H tumors tended to be lower than that of microsatellite stable/MSI-low (MSS/L) tumors (1.49±3.15 vs 4.37±9.81; p=0.052), but the MSI-H phenotype was associated with the presence of lymphatic invasion (p=0.036) and IHC-positive occult LN metastasis (p=0.007). By multivariate analysis, MSI-H phenotype was significantly associated with IHC-positive occult LN metastasis (Odds ratio, 2.654; p=0.044). MSI status and occult LN metastasis were not prognostic factors by survival analysis. Our findings suggest that the relationship between MSI status and regional LN metastasis may have some clinical and biologic implications to be elucidated.

Breast metastases of gastric signet-ring cell carcinoma: a report of two cases and review of the literature.

It is occasionally difficult to diagnose breast metastasis of gastric carcinoma because of its rarity. However, to appropriately treat patients with breast tumors without delay, it is important to distinguish metastatic cancer from primary breast cancer. We report two cases of breast metastasis of gastric carcinoma and review the literature. The first case was a 41-year-old female diagnosed with bilateral pelvic tumors who visited the outpatient clinic because of pain and enlargement of both breasts. Ultrasonography showed diffuse hypoechoic lesions, which were enhanced on gadolinium-enhanced magnetic resonance imaging in the bilateral mammary gland. Core needle biopsy of the right breast revealed signet-ring cells, which were also identified in the resected bilateral pelvic tumors. Subsequent upper gastrointestinal endoscopy revealed signet-ring cell carcinoma in the stomach, and the bilateral breast lesions were diagnosed as metastases of gastric carcinoma. The second case was a 34-year-old female diagnosed with cervical metastasis of signet-ring cell carcinoma who was referred to the breast cancer clinic because of a nodule in the left breast detected by computed tomography. Ultrasonography showed a hypoechoic nodule that was enhanced on gadolinium-enhanced magnetic resonance imaging. Because the pathologic findings for the left breast nodule were quite similar to those of gastric cancer and its cervical metastasis, the breast nodule was diagnosed as a metastasis of gastric carcinoma. When a breast tumor is suspected to have metastasized from a primary tumor in another organ, particularly if signet-ring cells are found, the possibility that gastric cancer is present should be considered.

High expression of astrocyte elevated gene-1 is associated with clinical staging, metastasis, and unfavorable prognosis in gastric carcinoma.

More and more evidence has demonstrated that astrocyte elevated gene-1 (AEG-1) is tightly associated with progression, metastasis, and unfavorable prognosis in many malignancies. However, the potential biological role of AEG-1 in gastric carcinoma (GC) has not been thoroughly delineated. In the current study, we found that AEG-1 mRNA and protein levels in GC tissues were significantly higher than those in normal gastric mucosa (P < 0.05). Simultaneously, statistical analysis displayed a significant correlation of high AEG-1 mRNA and protein expressions with differentiation status, TNM staging, invasive depth, and lymph node metastasis (P < 0.05). Most importantly, expressions of AEG-1 mRNA and protein in high clinical staging and metastatic GC tissues were dramatically higher than those in low clinical staging and non-metastatic GC tissues (P < 0.05). Stepwise investigation confirmed that the survival time of the patients with high AEG-1 level was shorter than those with low AEG-1 level or negative AEG-1 staining. Taken altogether, our data presented herein suggest that AEG-1 may be a novel predictor for metastasis and prognosis of the patients with GC.