Epithelial-Mesenchymal Transition Phenotype Is Associated with Patient Survival in Small Intestinal Adenocarcinoma
Hyung Chan Shin, Aeri Kim, Young Kyung Bae, Mi Jin Gu, Eun Sun Jung, Young-Ha Oh, Han-Ik Bae, Hee Jin Lee, Seung-Mo Hong. Yeungnam University College of Medicine, Daegu, Republic of Korea; Catholic University of Korea College of Medicine, Seoul, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Kyungpook National University School of Medicine, Daegu, Republic of Korea; Seoul National University Bundang Hospital, Seongnam, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
Background: Small intestinal adenocarcinomas (SIACs) are rare, and their molecular pathogenesis is largely unknown. Epithelial-mesenchymal transition (EMT) of epithelial tumor is defined as a reversible process characterized by loss of epithelial characteristics and acquisition of a mesenchymal phenotype. We investigated the clinical significance of EMT in SIACs based on the expression pattern of EMT-related proteins.
Design: We performed immunohistochemistry for epithelial (E-cadherin and β-catenin) and mesenchymal (vimentin and fibronectin) markers on tissue microarray slides constructed with 194 SIACs. Based on the combined results, we divided the 194 cases into three groups: complete EMT type (negative for epithelial markers and positive for any mesenchymal marker), wild type (positive for any epithelial marker and negative for mesenchymal markers) and incomplete type (neither complete nor wild type). And the data were compared with clinicopathologic factors, including overall survival of SIAC patients.
Results: Complete EMT phenotype was observed in 7.6% (14/184 informative cases) of SIACs. Wild and incomplete phenotype consisted of 63.6% (117/184) and 28.8% (53/184) of SIACs, respectively. Complete EMT phenotype was significantly associated with polypoid growth pattern (P=0.01), undifferentiated carcinoma (P<0.001), advanced pT classification (P=0.03) and presence of lymphovascular invasion (P=0.05). Overall survival for SIAC patients with complete EMT phenotype was significantly shorter than those for patients with incomplete and wild types, as determined by univariate (P<0.001) and multivariate analyses (P<0.001).
Conclusions: In conclusion, complete EMT phenotype was significantly associated with major clinicopathologic parameters and it was an independent prognostic factor for overall survival in patients with SIACs.
Tuesday, March 5, 2013 1:00 PM
Poster Session IV # 107, Tuesday Afternoon