Relationship between biological behavior and phenotypic expression in undifferentiated-type gastric carcinomas.
BACKGROUND
It has been proved that some differentiated-type gastric carcinomas have a gastric phenotype. Similarly, it can be conjectured that some undifferentiated-type gastric carcinomas have an intestinal phenotype and that there are biological differences between undifferentiated-type gastric carcinomas with a gastric phenotype and those with an intestinal phenotype. We classified the phenotypes of early undifferentiated-type gastric carcinomas and investigated the relationship between their biological behavior and the phenotypes.


METHODS
Sixty lesions of intramucosal undifferentiated-type gastric carcinoma were classified into four phenotypes; gastric type, incomplete-intestinal type, complete-intestinal type, and unclassified type, according to the expression of CD10, MUC2, small-intestinal mucinous antigen (SIMA), human gastric mucin (HGM), or concanavalin A (ConA).


RESULTS
The incidence of gastric-type carcinoma, incomplete-intestinal-type carcinoma, and complete-intestinal-type carcinoma was 33% (20 cases), 65% (39 cases), and 2% (1 case), respectively. There was no significant difference in any of the clinicopathological factors examined between the 20 gastric-type carcinomas and the 40 intestinal-type carcinomas, but there were significant differences in the morphological findings. Intestinal-type carcinomas had a glandular structure more frequently than the gastric-type carcinomas. The spreading pattern of gastric-type carcinomas showed a middle-layer type more frequently than the intestinal-type carcinomas.


CONCLUSIONS
Undifferentiated-type gastric carcinomas frequently expressed an intestinal phenotype. There were differences in the growth patterns between undifferentiated-type gastric carcinomas with a gastric phenotype and those with the intestinal phenotype.
Kabashima
Akira
A
Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
Yao
Takashi
T
Maehara
Yoshihiko
Y
Tsuneyoshi
Masazumi
M
D000230:Adenocarcinoma / Q000378:metabolism / Q000473:pathology*; D000951:Antigens, Neoplasm / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000378:metabolism; D002454:Cell Differentiation; D003208:Concanavalin A / Q000378:metabolism; D005260:Female; D005752:Gastric Mucins / Q000145:classification / Q000378:metabolism; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D055262:Mucin-2; D009077:Mucins / Q000378:metabolism; D015260:Neprilysin / Q000378:metabolism; D010641:Phenotype; D013274:Stomach Neoplasms / Q000378:metabolism / Q000473:pathology*
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D005752:Gastric Mucins; C524625:MUC2 protein, human; D055262:Mucin-2; D009077:Mucins; C042384:gastro-intestinal mucus-associated antigens; D003208:Concanavalin A; D015260:Neprilysin