title: Co-expression of gastric and biliary phenotype in pyloric-gland type adenoma of the gallbladder: immunohistochemical analysis of mucin profile and CD10.
abstract: Pyloric-gland type adenoma of the gallbladder is formed by proliferation of glands resembling pyloric glands, morphologically. No previous report has described the cellular phenotype and differentiation of pyloric-gland type adenoma of the gallbladder, using CD10 as a marker of proper biliary phenotype. Immunostainings were performed for mucin markers such as MUC5AC, human gastric mucin (HGM) for gastric foveolar type epithelium, MUC6, M-GGMC-1 for pyloric-gland type and MUC2 for intestinal goblet-cell type, and for CD10 as a proper biliary type marker on 58 pyloric-gland type adenomas of the gallbladder, as well as for p53, Ki-67 and CDX2. The percentage (X) of reactive cells in relation to the total number of tumor cells was estimated semi-quantitatively, and divided into four categories: X=0% (negative), 0%<X<10%, 10%<or=X<30%, and X>or=30%. CDX2 expression was considered to be positive when the percentage of positively stained cells was >or=10%. Out of the 58 pyloric-gland type adenomas, >or=30% of adenoma cells were positive for MUC5AC in 22 (38%) tumors, HGM in 29 (50%), MUC6 in 58 (100%), M-GGMC-1 in 54 (93%), MUC2 in none (0%), and CD10 in 20 (34%). MUC6 (P<0.001) and M-GGMC-1 (P<0.001) mucins were detected more frequently in pyloric-gland type adenomas, and CD10 expression was significantly decreased, compared with normal gallbladder epithelium (P=0.006). P53 overexpression was not found in any of the 58 tumors, including two adenomas with carcinomatous foci. The mean number of Ki-67-positive cells was 10.3+/-5.8%. CDX2 expression was judged as negative in all 58 pyloric-gland type adenomas. In pyloric-gland type adenomas of the gallbladder, expression of pyloric-gland type mucins was observed with a high frequency, whereas intestinal goblet-cell mucins were rarely seen. In addition, co-expression of gastric foveolar type mucins and CD10 was also demonstrated. Pyloric-gland type adenomas of the gallbladder show a differentiation toward pyloric glands in terms of immunohistochemistry, as well as morphology, accompanied by co-expression of gastric foveolar and native biliary phenotypes.
authors.affiliation: Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka 812-8582, Japan. shnagata@surgpath.med.kyushu-u.ac.jp
authors.forename: Shigenori
authors.initials: S
authors.lastname: Nagata
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Ajioka
authors.forename: Ken
authors.initials: K
authors.lastname: Nishikura
authors.forename: Gen
authors.initials: G
authors.lastname: Watanabe
authors.forename: Takahiro
authors.initials: T
authors.lastname: Inoue
authors.forename: Koji
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: Hidenobu
authors.initials: H
authors.lastname: Watanabe
authors.forename: Masao
authors.initials: M
authors.lastname: Tanaka
authors.forename: Masazumi
authors.initials: M
authors.lastname: Tsuneyoshi
mesh_terms: D000236:Adenoma / Q000737:chemistry* / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001659:Biliary Tract / Q000737:chemistry / Q000473:pathology; D000071616:CDX2 Transcription Factor; D005260:Female; D005706:Gallbladder Neoplasms / Q000737:chemistry* / Q000473:pathology*; D005753:Gastric Mucosa / Q000737:chemistry / Q000473:pathology; D018398:Homeodomain Proteins / Q000032:analysis; D006801:Humans; D007120:Immunochemistry; D019394:Ki-67 Antigen / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009077:Mucins / Q000032:analysis*; D015260:Neprilysin / Q000032:analysis*; D010641:Phenotype; D013270:Stomach / Q000737:chemistry / Q000473:pathology; D016159:Tumor Suppressor Protein p53 / Q000032:analysis
chemical_list: D000071616:CDX2 Transcription Factor; C491270:CDX2 protein, human; D018398:Homeodomain Proteins; D019394:Ki-67 Antigen; D009077:Mucins; D016159:Tumor Suppressor Protein p53; D015260:Neprilysin