[Expression of p27 and proliferative (MIB-1), mitotic (MI) and apoptotic indices in early-phase (EGF) gastric carcinoma. Results of a study by the Italian Gastric Cancer Research Group (IRGGC)].
OBJECTIVE
Since the Japanese Society for Gastroenterology and Endoscopy (JSGE) introduced the definition of Early Gastric Cancer (EGC), much more and deeper studies were done, which demonstrated that EGC was a more complex phase of the neoplastic disease with different morphologic characteristics, tightly linked to the prognosis. We evaluated the clinical impact of some prognostic factors, known being important in the advanced lesions, in a series of EGC patients with special reference to the clinicomorphological features.


RESULTS
We analysed the mitotic (MI) and apoptotic (AI) indices and the immunohistochemical expression of p27 and MIB-1 in 83 EGC cases consecutively recruited in the hospitals of Forlì, Verona, Siena and Milan (IRGGC) in the period 1994-95. The classifications of JSGE, Lauren and Kodama were used to define the macroscopic, microscopic and growth pattern types, respectively. Decreased p27 expression correlated with the macroscopic escavated lesions and diffused mixed histotypes; the increase of MIB-1 detection with tumour size larger than 2 cm, but lesser than 4 cm; MI with intestinal histologic types and AI with mucosal and penetrating lesions, according to Kodama. Statistical analysis showed significative correlations among MIB-1, MI and AI, but not with p27 and the other variables. All these factors did not influence the prognosis of our patients.


CONCLUSIONS
In our series, p27, MIB-1, MI, and AI did not add any useful clinical. So, in EGC patients the morphological features have still the most important role in influencing the prognosis and treatment of patients.
U.O. di Anatomia Patologica e Chirurgia Ospedali di Forlì, Italia. lsaragon@ausl.fo.it
L
L
Saragoni
P
P
Morgagni
G
G
De Manzoni
A
A
Tomezzoli
F
F
Roviello
D
D
Marrelli
A
A
Di Leo
C
C
Vindigni
H
H
Kurihara
P
P
Fociani
D017209:Apoptosis; D014408:Biomarkers, Tumor / Q000032:analysis*; D002277:Carcinoma / Q000737:chemistry / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D018797:Cell Cycle Proteins / Q000032:analysis*; D050760:Cyclin-Dependent Kinase Inhibitor p27; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods; D006801:Humans; D007558:Italy / Q000453:epidemiology; D019394:Ki-67 Antigen / Q000032:analysis*; D015993:Life Tables; D008197:Lymph Node Excision; D008940:Mitotic Index; D009363:Neoplasm Proteins / Q000032:analysis*; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000737:chemistry / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D016019:Survival Analysis; D016896:Treatment Outcome; D025521:Tumor Suppressor Proteins / Q000032:analysis*
D014408:Biomarkers, Tumor; D018797:Cell Cycle Proteins; D019394:Ki-67 Antigen; D009363:Neoplasm Proteins; D025521:Tumor Suppressor Proteins; D050760:Cyclin-Dependent Kinase Inhibitor p27