title: The presence of a micropapillary component predicts aggressive behaviour in early and advanced gastric adenocarcinomas.
abstract: OBJECTIVE
  A micropapillary component (MC) consists of small tight clusters of tumour cells surrounded by clear spaces resembling lymphatic tumour emboli. Carcinoma with a MC has recently been described as a highly aggressive variant. However, little is known about the clinicopathological significance of the MC in gastric adenocarcinoma.
  
  
  METHODS
  We investigated the clinicopathological characteristics of gastric adenocarcinoma with a MC and compared them with those of conventional gastric adenocarcinoma.
  
  
  RESULTS
  Among 172 cases, 23 (13.4%) cases had a MC. The amount of micropapillary growth pattern in entire tumour areas ranged from 10% to 80%. The presence of a MC in gastric adenocarcinoma was significantly associated with the depth of invasion, lymph node metastasis, lymphovascular invasion, perineural invasion, higher clinical stages, and poor overall survival rates, but not with age, gender, tumour size, location, and Lauren histological types. The MC was present in four (4.7%) of 86 early gastric cancers and all but one of the early gastric cancers with a MC showed lymph node metastasis (p = 0.02).
  
  
  CONCLUSIONS
  Recognition of a MC in early and advanced gastric adenocarcinomas is very important as it can predict cancer invasion and metastasis leading to a poor clinical outcome.
authors.affiliation: Department of Pathology, Korea University Ansan Hospital, Ansan, Gyeonggi-Do, Korea.
authors.forename: Ju-Han
authors.initials: JH
authors.lastname: Lee
authors.forename: Jong-Han
authors.initials: JH
authors.lastname: Kim
authors.forename: Jung-Woo
authors.initials: JW
authors.lastname: Choi
authors.forename: Young-Sik
authors.initials: YS
authors.lastname: Kim
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology*; D009367:Neoplasm Staging; D011379:Prognosis; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology*; D055815:Young Adult