title: Exocrine and endocrine modulation in common gastric carcinoma.
abstract: Diagnostic and prognostic implications of endocrine differentiation were evaluated in 103 common gastric adenocarcinomas and undifferentiated carcinomas. Maturely differentiated exocrine and endocrine phenotypes were evaluated by using gastric exocrine and endocrine markers along with intestinal exocrine and endocrine markers. Immunohistochemical analysis revealed that 66 tumors (64%) were positive for generic endocrine markers such as chromogranin A and/or synaptophysin. The 14 patients with more than 20% tumor cells positive for at least 1 endocrine marker experienced a poorer prognosis than patients with no (n = 37) or 1% to 20% (n = 52) positivity. The 16 carcinomas expressing the maturely differentiated exocrine gastric phenotype significantly correlated with poorer outcome compared with carcinomas with mature exocrine intestinal (n = 22) or mixed/gastrointestinal (n = 64) phenotypes. Among tumors expressing chromogranin A and/or synaptophysin, the maturely differentiated endocrine gastric phenotype (n = 26) was a negative prognostic factor compared with mature endocrine intestinal (n = 21) and mixed/gastrointestinal (n = 5) phenotypes. Endocrine differentiation and maturely exocrine/endocrine gastric phenotypes are associated with an unfavorable prognosis and may identify subsets of patients for tailored therapy.
authors.affiliation: Division of Pathology, CRO-National Cancer Institute, IRCCS, Aviano, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Canzonieri
authors.forename: Cristina
authors.initials: C
authors.lastname: Colarossi
authors.forename: Laura
authors.initials: L
authors.lastname: Del Col
authors.forename: Tiziana
authors.initials: T
authors.lastname: Perin
authors.forename: Renato
authors.initials: R
authors.lastname: Talamini
authors.forename: Roberto
authors.initials: R
authors.lastname: Sigon
authors.forename: Renato
authors.initials: R
authors.lastname: Cannizzaro
authors.forename: Eleonora
authors.initials: E
authors.lastname: Aiello
authors.forename: Angela
authors.initials: A
authors.lastname: Buonadonna
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Italia
authors.forename: Daniela
authors.initials: D
authors.lastname: Massi
authors.forename: Antonino
authors.initials: A
authors.lastname: Carbone
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Memeo
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism; D002277:Carcinoma / Q000378:metabolism / Q000473:pathology*; D053379:Chromogranin A / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013274:Stomach Neoplasms / Q000378:metabolism / Q000473:pathology*; D016708:Synaptophysin / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor; D053379:Chromogranin A; D016708:Synaptophysin