LI-cadherin: a marker of gastric metaplasia and neoplasia.
BACKGROUND
Intestinal metaplasia is considered a risk factor for the development of gastric adenocarcinomas of the intestinal type and is found in approximately 20% of gastric biopsies. Conventional histology only detects advanced stages of intestinal metaplasia.


OBJECTIVE
To study expression of the enterocyte specific adhesion molecule liver-intestinal (LI)-cadherin in intestinal metaplasia as well as in gastric cancer, and to evaluate its use as a diagnostic marker molecule.


METHODS
Gastric biopsies (n=77) from 30 consecutive patients (n=30; aged 28-90 years) as well as surgically resected tissue samples (n=24) of all types of gastric carcinomas were analysed.


METHODS
Single and double label immunofluorescence detection on cryosections of gastric biopsies; alkaline phosphatase antialkaline phosphatase method on paraffin embedded carcinoma tissue sections.


RESULTS
Of 77 biopsies (from 30 patients), 12 (from 10 patients) stained positive for LI-cadherin. LI-cadherin staining correlated with the presence of intestinal metaplasia. Conventional histological diagnosis however failed to detect subtle gastric intestinal metaplasia (three of 10 patients). In contrast, only LI-cadherin and villin were positive in these cases whereas sucrase-isomaltase also failed to detect intestinal metaplasia in four of 10 patients. Well differentiated gastric carcinomas showed intense staining for LI-cadherin while undifferentiated carcinomas showed only weak diffuse cytoplasmic staining.


CONCLUSIONS
To detect early metaplastic changes in the gastric mucosa, LI-cadherin has a sensitivity superior to sucrase-isomaltase and conventional histology and comparable with that of villin. Its specificity exceeds that of villin. Thus LI-cadherin represents a new, reliable, and powerful marker molecule for early detection of gastric intestinal metaplasia and well differentiated adenocarcinomas.
Grötzinger
C
C
Department of Internal Medicine, Division of Hepatology and Gastroenterology, Charité Medical School of the Humboldt University of Berlin, Berlin, Germany.
Kneifel
J
J
Patschan
D
D
Schnoy
N
N
Anagnostopoulos
I
I
Faiss
S
S
Tauber
R
R
Wiedenmann
B
B
Gessner
R
R
D000230:Adenocarcinoma / Q000378:metabolism*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism*; D001706:Biopsy; D015153:Blotting, Western; D015820:Cadherins; D002352:Carrier Proteins / Q000378:metabolism*; D004591:Electrophoresis, Polyacrylamide Gel; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D005753:Gastric Mucosa / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D015151:Immunoblotting; D008297:Male; D026901:Membrane Transport Proteins; D008679:Metaplasia / Q000378:metabolism; D008856:Microscopy, Fluorescence; D008875:Middle Aged; D016612:Paraffin Embedding; D013274:Stomach Neoplasms / Q000378:metabolism*
D014408:Biomarkers, Tumor; C490584:CDH17 protein, human; D015820:Cadherins; D002352:Carrier Proteins; D026901:Membrane Transport Proteins; C067802:intestinal peptide-proton cotransporter