[Clinicopathological features and differences of p53 and Ki-67 expression in adenosquamous and squamous cell carcinomas of the stomach].
OBJECTIVE
This study reviews the clinicopathological features, prognosis, and differences in the expression of p53 and Ki-67 immunochemical staining in squamous cell and adenosquamous carcinoma of the stomach.


METHODS
From January 1995 to June 2005, 2,282 cases of gastric carcinoma were resected surgically in our hospital and 191 additional cases were resected by endoscopic mucosal resection. Retrospective pathologic review and immunochemical staining of p53 and Ki-67 were performed.


RESULTS
The study consists of eight cases (0.032%) of primary squamous cell carcinoma (one case) and adenosquamous carcinoma (seven cases) without early gastric cancer. Six cases (75.0%) were male and two cases were female. The mean age was 66 year-old. The clinical presentation and physical findings did not differ from those of adenocarcinoma. The mean tumor size was 5.2+/-1.7 cm. Macroscopically, five were Borrmann type 3 (62.5%) and three were type 2. At the initial diagnosis, six (75%) were stage IV based on TNM tumor staging. Six cases (75%) progressed despite the therapy while two cases responded to the treatment. The median survival time was 11.0 months (range 4.3+/-17.7). Overexpression of p53 was seen in five cases (62.5%) and their survival was poor when compared to the p53-negative group (p=0.04). The mean Ki-67 labeling index was 70.0+/-20.8%, and was not associated with p53 staining (p<0.05).


CONCLUSIONS
Adenosquamous and squamous cell carcinoma of the stomach are very rare. They tend to be at advanced stages on initial diagnosis, and progress rapidly. They show p53 protein overexpression and high Ki-67 labeling index, which might be related to poor prognosis.
Kim
Yeon Soo
YS
Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea.
Heo
Won Seok
WS
Chae
Kyung Hoon
KH
Gang
Youn Se
YS
Jung
Jae Hoon
JH
Kim
Seok Hyun
SH
Seong
Jae Koo
JK
Lee
Byung Seok
BS
Jeong
Hyun Yong
HY
Song
Kyu Sang
KS
Shin
Kyung Sook
KS
Cho
June Sick
JS
Noh
Seung Moo
SM
D000328:Adult; D000368:Aged; D018196:Carcinoma, Adenosquamous / Q000737:chemistry / Q000401:mortality / Q000473:pathology*; D002294:Carcinoma, Squamous Cell / Q000737:chemistry / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000737:chemistry / Q000401:mortality / Q000473:pathology*; D015996:Survival Rate; D016159:Tumor Suppressor Protein p53 / Q000032:analysis*
D019394:Ki-67 Antigen; D016159:Tumor Suppressor Protein p53