title: Tumor cell proliferation in early gastric cancer: biological and clinical behavior.
abstract: 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.
authors.affiliation: Clinica Chirurgica, Universitá degli Studi dell'Insubria-Varese, Italy. p.dionigi@smatteo.pv.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Dionigi
authors.forename: Alberta
authors.initials: A
authors.lastname: Ferrari
authors.forename: Vassili
authors.initials: V
authors.lastname: Jemos
authors.forename: Orietta
authors.initials: O
authors.lastname: Luinetti
authors.forename: Luciano
authors.initials: L
authors.lastname: Vai
authors.forename: Michela
authors.initials: M
authors.lastname: Guizzetti
authors.forename: Cinzia
authors.initials: C
authors.lastname: Ferrari
authors.forename: Kostantinos
authors.initials: K
authors.lastname: Jemos
authors.forename: Marco
authors.initials: M
authors.lastname: Spada
authors.forename: Giuliano
authors.initials: G
authors.lastname: Mazzini
mesh_terms: 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
chemical_list: D000964:Antimetabolites, Antineoplastic; D001973:Bromodeoxyuridine