title: Analysis of mucin, p53 protein and Ki-67 expressions in gastric differentiated-type intramucosal neoplastic lesions obtained from endoscopic mucosal resection samples: a proposal for a new classification of intramucosal neoplastic lesions based on nuclear atypia.
abstract: There are differing views between Western and Japanese pathologists on the use of histological criteria to classify gastrointestinal tumors. It is therefore a priority to create a new histological classification of the stomach in order to resolve the confusion. Expression patterns were examined of mucin (MUC2, CD10, MUC5AC, pyloric gland-type mucin), p53 protein, and Ki-67 in tumor cells according to the following new classification system for differentiated-type intramucosal neoplastic lesions of the stomach, based on nuclear atypia: borderline neoplasia (adenoma (including dysplasia), indefinite tumor of adenoma or low-grade cancer, and low-grade cancer) and definite carcinoma (intermediate cancer, and high-grade cancer). The resulting grades were: adenoma, 23; indefinite tumor for adenoma or low-grade cancer, 6; low-grade cancer, 28; intermediate cancer, 48; high-grade cancer, 20. While the frequency of intestinal-type borderline neoplasias was higher than that of definite carcinomas, the mixed-type of definite carcinomas occurred with higher frequency than borderline neoplasias. The p53 protein overexpression and the Ki-67-positive rate increased with an increase in the grade assigned according to the new classification. The correlated expression levels of p53 protein, Ki-67, and various mucins, support the conclusion that this classification of intramucosal neoplastic lesions is useful for obtaining a consensus diagnosis of gastric intramucosal neoplasia between pathologists and gastrointestinal clinicians.
authors.affiliation: Division of Pathology, Central Clinical Laboratory, Iwate Medical University, Morioka, Japan. tsugai@cocoa.ocn.ne.jp
authors.forename: Tamotsu
authors.initials: T
authors.lastname: Sugai
authors.forename: Masaaki
authors.initials: M
authors.lastname: Inomata
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Uesugi
authors.forename: Yu-Fei
authors.initials: YF
authors.lastname: Jiao
authors.forename: Masaki
authors.initials: M
authors.lastname: Endoh
authors.forename: Seishi
authors.initials: S
authors.lastname: Orii
authors.forename: Shin-Ichi
authors.initials: S
authors.lastname: Nakamura
mesh_terms: D000230:Adenocarcinoma / Q000145:classification / Q000378:metabolism* / Q000473:pathology; D000236:Adenoma / Q000145:classification / Q000378:metabolism* / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism; D005260:Female; D005752:Gastric Mucins / Q000378:metabolism*; D005753:Gastric Mucosa / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D005773:Gastroscopy; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D013274:Stomach Neoplasms / Q000145:classification / Q000378:metabolism* / Q000473:pathology; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism*
chemical_list: D014408:Biomarkers, Tumor; D005752:Gastric Mucins; D019394:Ki-67 Antigen; D016159:Tumor Suppressor Protein p53