title: Gastric pit dysplasia in adjacent gastric mucosa in 414 gastric cancers: prevalence and characteristics.
abstract: Despite wide acceptance of the chronic gastritis-intestinal metaplasia-dysplasia-carcinoma sequence, especially for intestinal-type gastric adenocarcinoma, the precise nature of the subtle precursor lesions of gastric cancer remains to be delineated. For example, pit dysplasia with surface foveolar maturation is not well defined, nor is its prevalence and biological characteristics well characterized. We have evaluated the surrounding gastric mucosa of 414 gastric cancers for the presence of gastric pit dysplasia. We investigated its relationship with various clinicopathological and immunophenotypic features of gastric adenocarcinoma, as well as the severity and extent of any surrounding gastritis and intestinal metaplasia. p53 expression and Ki-67 proliferation index were also evaluated. We have found that 21.0% (n=87) of gastric cancer cases showed pit dysplasia in adjacent gastric mucosa. Gastric cancers with pit dysplasia were significantly associated with older age, male sex, body/fundic location, and intestinal histologic type (P<0.05). Interestingly, gastric mucin-containing intestinal metaplasia (incomplete intestinal metaplasia) was highly associated with adenocarcinoma with pit dysplasia (P=0.000). In addition, MUC6 expression in gastric adenocarcinoma was associated with pit dysplasia (P=0.036). p53 overexpression and increased Ki-67 proliferation index were more evident in gastric pit dysplasia compared with adjacent gastric mucosa. We suggest that gastric pit dysplasia is an important candidate precursor of gastric adenocarcinoma and may represent another morphologic step in the pathogenesis of gastric adenocarcinoma, especially of intestinal type. More detailed prospective studies are needed to determine the precise significance of these findings.
authors.affiliation: Department of Pathology, Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Nari
authors.initials: N
authors.lastname: Shin
authors.forename: Hong-Jae
authors.initials: HJ
authors.lastname: Jo
authors.forename: Woo-Kyung
authors.initials: WK
authors.lastname: Kim
authors.forename: Won-Young
authors.initials: WY
authors.lastname: Park
authors.forename: Jeong-Hee
authors.initials: JH
authors.lastname: Lee
authors.forename: Dong Hun
authors.initials: DH
authors.lastname: Shin
authors.forename: Kyung Un
authors.initials: KU
authors.lastname: Choi
authors.forename: Jee-Yeon
authors.initials: JY
authors.lastname: Kim
authors.forename: Chang-Hun
authors.initials: CH
authors.lastname: Lee
authors.forename: Mee Young
authors.initials: MY
authors.lastname: Sol
authors.forename: Tae Yong
authors.initials: TY
authors.lastname: Jeon
authors.forename: Dae Whan
authors.initials: DW
authors.lastname: Kim
authors.forename: Gi-Young
authors.initials: GY
authors.lastname: Huh
authors.forename: Gwang Ha
authors.initials: GH
authors.lastname: Kim
authors.forename: Gregory Y
authors.initials: GY
authors.lastname: Lauwers
authors.forename: Do Youn
authors.initials: DY
authors.lastname: Park
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism / Q000473:pathology*; D000328:Adult; D000368:Aged; D049109:Cell Proliferation; D018450:Disease Progression; D005260:Female; D005753:Gastric Mucosa / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000378:metabolism / Q000473:pathology*; D013274:Stomach Neoplasms / Q000378:metabolism / Q000473:pathology*; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism
chemical_list: D019394:Ki-67 Antigen; D016159:Tumor Suppressor Protein p53