Tumor cell proliferation in early gastric cancer: biological and clinical behavior.
OBJECTIVE
Recently, early gastric cancers without lymph node metastasis have successfully been removed through a simple endoscopic resection. Tumor cell proliferation may be related to the malignant potential of early gastric cancer. The purpose of this study is to prospectively investigate the relationship between the incorporation rate of bromodeoxyuridine (BrdU) into the DNA of dividing cells, and the main biological and clinical early gastric cancer characteristics.


METHODS
Multiple tumor specimens were taken from 27 early gastric cancers and analyzed through anti-BrdU monoclonal antibody. Tumor BrdU labeling index (LI=% positive cells over 2,000 tumor cells) was determined. Early gastric cancers were evaluated in tumor size, mucosal and submucosal involvement, histologic type and grading, lymphatic and venous invasion, and nodal metastasis.


RESULTS
BrdU LI was significantly higher in patients with submucosal neoplastic invasion, Pen A Kodama type, tumor vessel invasion and lymph node involvement. Early gastric cancer patients with over 22% BrdU LI showed a significantly higher incidence of submucosal invasion, lymphatic-venous involvement and a reduced survival when compared to patients with medium (12-22%) or low BrdU LI (<12%).


CONCLUSIONS
Our results suggest that BrdU LI may be considered a useful indicator of early gastric cancer aggressiveness.
Dionigi
Paolo
P
Clinica Chirurgica, Universitá degli Studi dell'Insubria-Varese, Italy. p.dionigi@smatteo.pv.it
Ferrari
Alberta
A
Jemos
Vassili
V
Luinetti
Orietta
O
Vai
Luciano
L
Guizzetti
Michela
M
Ferrari
Cinzia
C
Jemos
Kostantinos
K
Spada
Marco
M
Mazzini
Giuliano
G
D000368:Aged; D000964:Antimetabolites, Antineoplastic; D001808:Blood Vessels / Q000473:pathology; D001973:Bromodeoxyuridine; D002455:Cell Division; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D011446:Prospective Studies; D013274:Stomach Neoplasms
D000964:Antimetabolites, Antineoplastic; D001973:Bromodeoxyuridine