Mucin Phenotype and beta-Catenin Are Useful Markers To Predict Submucosal Invasion and Lymph Node Metastasis in Intestinal Type Early Gastric Cancer
HJ Kang, HY Kim, GH Kim, DH Shin, GA Song, DH Kim, TY Jeon, DH Kim, BM Cho, GY Lauwers, DY Park. Pusan National University Hospital, Busan, Korea; School of Medicine Pusan National University, Busan, Korea; Massachusetts General Hospital, Boston, MA
Background: With the increasing therapeutic use of endoscopic resection for intestinal early gastric cancer (EGC), it is very important to predict biological behaviors of intestinal type EGC prior to endoscopic resection. On this background, we tried to elucidate the presumptive clinicopathologic factors and biologic markers to predict submucosal invasion and lymph node metastasis based on mucin expression in EGCs.
Design: 130 cases of intestinal EGCs were divided as EGC-IPs (EGCs with intestinal mucin phenotypes) and EGC-GPs (ICs with intestinal mucin phenotypes) based on mucin expression. The expression of mucins (Muc2, Muc5Ac, Muc6, CD10), other protein markers (p53, CDX2, beta-catenin, E-cadherin, Smad4) by immunohistochemistry were studied.
Results: EGC-IPs showed significantly increased p53 expression, CDX2 expression and beta-catenin delocalization than EGC-GPs. Using binary logistic regression analysis, expression of both gastric mucin and nuclear beta catenin expression could be independent predictive factors of lymph node metastasis (p=0.004) and submucosal invasion (0.007) in intestinal EGCs. Lymphovascular emboli (p=0.001), and size of lesion (p=0.022) could be clinicopathological independent predictive factors of lymph node metastasis and submucosal invasion in intestinal EGCs respectively.
Conclusions: Taken together, we suggest that mucin phenotype and beta-catenin expression might be used to predict biologic behavior prior to endoscopic mucosal resection in intestinal EGC.
Tuesday, March 10, 2009 1:00 PM
Poster Session IV # 101, Tuesday Afternoon