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Prognostic use of growth characteristics of early gastric cancer and expression patterns of apoptotic, cell proliferation, and cell adhesion proteins
Author(s) -
Pan Wensheng,
Ishii Hideaki,
Ebihara Yoshiro,
Gobe Glenda
Publication year - 2003
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.10204
Subject(s) - medicine , cell growth , apoptosis , adhesion , cell adhesion , cancer , cancer research , cell , protein expression , microbiology and biotechnology , oncology , biology , gene , biochemistry , chemistry , organic chemistry
Background and Objectives Selection of suitable treatment for early gastric cancers, such as endoscopic mucosal resection or the major surgical option of resection of the cancer together with a radical lymph node dissection, may be assisted by comparing the growth characteristics of the cancer with selected molecular characteristics. The results could be used to predict those cases that have a higher risk of developing secondary metastases. Methods A total of 1,196 Japanese patients with early gastric cancers (648 mucosal cancers and 548 submucosal) were included in the selection of two groups: a metastatic group made up 57 cancers with lymph node metastasis (9 mucosal, 48 submucosal), and a nonmetastatic group of 61 cases (6 mucosal, 55 submucosal) without lymph node metastasis. Growth characteristics of the cancers (superficially spreading, penetrating or invasive, lymph node metastasis) were compared with immunohistochemical expression of single‐stranded DNA (ssDNA) protein (apoptosis indicator), bcl‐2 and p53 (apoptosis‐associated), Ki‐67 (cell proliferation), and E‐cadherin (cell adhesion) proteins. Results The lesions in the nonmetastatic group had higher levels of apoptosis and lower expression of bcl‐2 than in the metastatic group, indicating an inhibitory role for apoptosis in malignant progression. Apoptosis was also higher in the superficial compared with the invasive lesions of both groups. The lesions in the metastatic group had higher p53 expression than that of the nonmetastatic group, whereas apoptosis in the metastatic group was lower than in the nonmetastatic group. An unproved explanation for this finding may be that, although increased, p53 was mutated and ineffective in promoting apoptotic control of metastatic progression. E‐cadherin was decreased in the invasive lesions of both groups, indicating a greater ability of these cells to lose adhesion, to invade the submucosa, and to metastasize. Cell proliferation was highest in the superficial lesions of both metastatic and nonmetastatic groups. Conclusions Early gastric cancers with low levels of apoptosis, increased bcl‐2, and high levels of p53 expression are more likely to invade and metastasize. J. Surg. Oncol. 2003;82:104–110. © 2003 Wiley‐Liss, Inc.