title: Gastric phenotypic expression and histogenesis of metachronous gastric cancers endoscopically resected.
abstract: OBJECTIVE
  Endoscopic Resection (ER) has been performed for early gastric cancers, and metachronous gastric cancers (MGCs) were occasionally observed. Most MGCs were classified histologically as the differentiated type. However, there have been no data on the gastric and intestinal phenotypic classification of MGCs. In our previous study, Hp-infection in MG may trigger intestinalization of gastric cancers. We therefore speculate the phenotype shift in MGC lesions under Hp-chronic-infection.
  
  
  METHODS
  We examined the 17 MGC lesions phenotypically and histologically by using several gastric and intestinal epithelial cell markers, MUC5AC, MUC6, MUC2 and villin.
  
  
  RESULTS
  Most lesions (16/17) exhibited the differentiated type. In 8 first cancers, the lesions were divided phenotypically into 2 G, 4 GI, 1 I, and 1 N types. In 9 second/third cancers, the lesions were divided phenotypically into 3 G, 1 GI, 4 I, and 1 N types. The first lesions (6/8) had more gastric phenotypic expression compared with the second/third ones (4/9) in the MGCs, although there was no significant difference between two groups (P = 0.28).
  
  
  CONCLUSIONS
  Our present data suggest the possibility that the cancer retaining G type is detected endoscopically earlier than that obtaining the intestinal phenotypic expression by the phenotypic shift, which may partially explain the MGC occurrence.
authors: Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, 1-Kawasumi, Mizuho-cho, Mizuho-ku Nagoya 467-8601, Japan.
authors: Tsutomu
authors: T
authors: Mizoshita
authors: Hiromi
authors: H
authors: Kataoka
authors: Satoshi
authors: S
authors: Tanida
authors: Makoto
authors: M
authors: Sasaki
authors: Naotaka
authors: N
authors: Ogasawara
authors: Eiji
authors: E
authors: Kubota
authors: Tsuneya
authors: T
authors: Wada
authors: Tomonori
authors: T
authors: Yamada
authors: Yoshinori
authors: Y
authors: Mori
authors: Takaya
authors: T
authors: Shimura
authors: Tetsuya
authors: T
authors: Tsukamoto
authors: Masae
authors: M
authors: Tatematsu
authors: Takashi
authors: T
authors: Joh
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D016009:Chi-Square Distribution; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000150:complications; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000473:pathology* / Q000601:surgery*; D010641:Phenotype; D013274:Stomach Neoplasms / Q000382:microbiology / Q000473:pathology* / Q000601:surgery*
chemical_list: D014408:Biomarkers, Tumor