A clinicopathologic study of 233 cases with special reference to evaluation with the MIB-1 index.
BACKGROUND
Few articles have analyzed the prognostic data from a large series of primary gastric lymphoma classified according to the concept of mucosa-associated lymphoid tissue (MALT).


METHODS
The resected specimens from 233 patients with primary gastric lymphoma were investigated retrospectively, including immunostaining with MIB-1 (Ki-67).


RESULTS
Histologically, 70 (30%) of the cases were low grade B-cell lymphoma of MALT, 27 (12%) low grade B-cell lymphoma of MALT with a focal high grade component, 100 (43%) high grade B-cell lymphoma of MALT, 15 (6%) other B-cell lymphomas, 14 (6%) T-cell lymphomas, and 7 (3%) undetermined. Macroscopically, 96 (41%) were superficial-spreading type, 100 (43%) mass-forming, 14 (6%) diffuse-infiltrating, and 23 (10%) unclassified. The MIB-1 index correlated with phenotype, histologic grade, stage, depth of invasion, and macroscopic type. A significantly better survival was noted for young patients, and those with tumors of a B-cell phenotype, histologic low grade, macroscopic superficial-spreading type, low stage, low depth of invasion, and low MIB-1 index. No significantly different survival rates were found between the patients who underwent gastric resection alone and those who also received additional chemotherapy. By Cox multivariate analysis, independent prognosticators included B-cell phenotype, low stage, and macroscopic superficial-spreading type.


CONCLUSIONS
In addition to stage, phenotype and macroscopic type are also important prognostic indicators of primary gastric lymphoma. Immunostaining with MIB-1 had limited independent value for predicting prognosis.
Nakamura
S
S
Second Department of Pathology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Akazawa
K
K
Yao
T
T
Tsuneyoshi
M
M
D034961:Antigens, Nuclear; D001324:Autoantigens / Q000032:analysis*; D014408:Biomarkers, Tumor / Q000032:analysis*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D016130:Immunophenotyping; D019394:Ki-67 Antigen; D016393:Lymphoma, B-Cell / Q000276:immunology / Q000473:pathology*; D018442:Lymphoma, B-Cell, Marginal Zone / Q000473:pathology; D016399:Lymphoma, T-Cell / Q000276:immunology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009687:Nuclear Proteins / Q000032:analysis*; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000276:immunology / Q000473:pathology*; D016019:Survival Analysis
D034961:Antigens, Nuclear; D001324:Autoantigens; D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; D009687:Nuclear Proteins