title: Prognostic significance of intestinal claudins in high-risk synchronous and metachronous multiple gastric epithelial neoplasias after initial endoscopic submucosal dissection.
abstract: Endoscopic submucosal dissection (ESD) is useful in en bloc curative resection and enables patients with early gastric carcinoma (GC) to have a better quality of life. But metachronous recurrence of GC at other sites in the stomach has become a major issue after initial ESD. The purpose of the present paper was to examine gastric (claudin-18) and intestinal claudin (claudin-3 and claudin-4) expression in early GC on immunohistochemistry to clarify the association with clinicopathology, mucin phenotypes, microsatellite instability (MSI) status and the incidence of synchronous and metachronous gastric epithelial neoplasias after initial ESD. According to intestinal claudin expression, a total of 73 early GC were divided into two groups: intestinal claudin-positive (I-CLDN(+)) phenotype (n = 52; 71%); and intestinal claudin-negative (I-CLDN(-)) phenotype (n = 21; 29%). Although no significant association was found with clinicopathology and the MSI status, the I-CLDN(+) early GC correlated with the mucin phenotypes and had a significantly higher incidence of synchronous and metachronous multiple GC and gastric adenomas (P = 0.049). These results indicate that early GC demonstrating I-CLDN(+) phenotype have a high risk of synchronous and metachronous secondary gastric epithelial neoplasias.
authors.affiliation: Division of Pathology, Department of Pathology and Microbiology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Shuho
authors.initials: S
authors.lastname: Semba
authors.forename: Tadateru
authors.initials: T
authors.lastname: Hasuo
authors.forename: Shinya
authors.initials: S
authors.lastname: Satake
authors.forename: Fumihito
authors.initials: F
authors.lastname: Nakayama
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yokozaki
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000235:genetics / Q000378:metabolism / Q000401:mortality; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism; D062465:Claudin-3; D062506:Claudin-4; D057167:Claudins; D004273:DNA, Neoplasm / Q000032:analysis; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D005773:Gastroscopy; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008565:Membrane Proteins / Q000378:metabolism*; D053842:Microsatellite Instability; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis* / Q000235:genetics / Q000378:metabolism; D010641:Phenotype; D011379:Prognosis; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000378:metabolism / Q000401:mortality; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor; C486683:CLDN18 protein, human; C568122:CLDN3 protein, human; C568157:CLDN4 protein, human; D062465:Claudin-3; D062506:Claudin-4; D057167:Claudins; D004273:DNA, Neoplasm; D008565:Membrane Proteins