The biologic features of intramucosal gastric carcinoma with lymph node metastasis.
This review concentrates on the clinicopathologic studies and molecular biologic studies of intramucosal gastric carcinomas (IMGCs) with lymph node metastasis that have been published to date. There have been several reports in which IMGCs with lymph node metastasis were compared with IMGCs without lymph node metastasis from the view of clinicopathologic features. However, there have been a few reports in which IMGCs with lymph node metastasis were compared with IMGCs without lymph node metastasis from the view of molecular biologic features. In general, IMGCs with lymph node metastasis have been commonly reported to be large lesions, poorly differentiated adenocarcinoma, and associated with peptic ulcer, in comparison with IMGCs without lymph node metastasis. Regarding genetic studies or molecular biologic studies, only DNA distribution pattern, proliferative cell nuclear antigen and the monoclonal antibody Ki-67, or matrix metalloproteinases 2 and 9 have been investigated in IMGCs with lymph node metastasis. The malignant potential of the carcinoma cells cannot been evaluated by a clinicopathologic study with the use of hematoxylin and eosin staining. It may be unavoidable that minimal operation is widely accepted for the treatment of IMGCs. It may be more essential to establish the staging by both clinicopathologic and molecular biologic examinations to rule out the presence of IMGCs with lymph node metastasis.
Kabashima
Akira
A
Department of Surgery and Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Maehara
Yoshihiko
Y
Koga
Tadashi
T
Kakeji
Yoshihiro
Y
Sugimachi
Keizo
K
D000230:Adenocarcinoma / Q000556:secondary*; D005753:Gastric Mucosa / Q000473:pathology*; D006801:Humans; D019394:Ki-67 Antigen / Q000032:analysis; D008207:Lymphatic Metastasis; D020778:Matrix Metalloproteinase 2 / Q000032:analysis; D020780:Matrix Metalloproteinase 9 / Q000032:analysis; D018809:Proliferating Cell Nuclear Antigen / Q000032:analysis; D013274:Stomach Neoplasms / Q000556:secondary*
D019394:Ki-67 Antigen; D018809:Proliferating Cell Nuclear Antigen; D020778:Matrix Metalloproteinase 2; D020780:Matrix Metalloproteinase 9