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Gastric neuroendocrine carcinoma: Clinicopathologic review and immunohistochemical study of E‐cadherin and Ki‐67 as prognostic markers
Author(s) -
Boo YoonJung,
Park SungSoo,
Kim JongHan,
Mok YoungJae,
Kim SeongJoo,
Kim ChongSuk
Publication year - 2007
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.20616
Subject(s) - medicine , ki 67 , immunohistochemistry , pathology , stomach , cancer , lymph node , metastasis , proliferation index , cadherin , proliferative index , gastroenterology , oncology , cell , genetics , biology
Background and Objectives Gastric neuroendocrine carcinoma (NEC) is an uncommon cancer of the stomach. The classification of NEC and its clinical behavior remains controversial, and prognostic markers and their therapeutic guidelines have not been clearly defined. The aim of this study was to evaluate the clinicopathologic characteristics of these tumors and analyze the expression of E‐cadherin and Ki‐67 as prognostic markers in gastric NECs. Methods We retrospectively reviewed 17 cases of gastric NECs. Tumor pathology was reviewed and the tumors were categorized as well‐differentiated NEC (n = 5) and poorly differentiated NEC (n = 12) according to the WHO classification. With the aim of evaluating the expression of E‐cadherin and Ki‐67 and their prognostic role in gastric NEC, immunohistochemical analysis of the tumors was performed. Results The median survival of patients was 20.0 months (95% confidence interval (CI), 13.2–28.8). There was a statistically significant difference in overall survival between well and poorly differentiated NECs ( P = 0.021). However, there was no significant difference in overall survival between patients with poorly differentiated small cell and large cell NEC ( P = 0.796). Loss of E‐cadherin was correlated with lymph node metastasis ( P = 0.044). A high Ki‐67 proliferation index (PI) (>60%) was correlated with tumor recurrence ( P = 0.013) and histologic differentiation ( P = 0.028). Conclusions Loss of E‐cadherin may predict lymph node metastasis in gastric NECs. A high Ki‐67 PI (>60%) could be used as a prognostic marker to predict aggressive gastric NECs in addition to standard pathologic classification. J. Surg. Oncol. 2007;95:110–117. © 2007 Wiley‐Liss, Inc.