title: The contribution of cell phenotype to the behavior of gastric cancer.
abstract: BACKGROUND
  Several histochemical studies suggest a role of tumor cell phenotype and related differentiation markers in the prognostic assessment of gastric cancer. Unfortunately, most studies have dealt with single or a few markers and have paid limited attention to their interplay with tumor histological types, which are potentially informative of prognosis.
  
  
  METHODS
  In this study, 292 invasive (T1b to T4) gastric cancers with prolonged follow-up and carefully analyzed histotype, inclusive of histotype-based grade, were investigated histochemically with a panel of 14 phenotypic markers known to be expressed in normal gut tissues and gastric cancer.
  
  
  RESULTS
  Three of seven intestinal type markers investigated showed a trend for improved prognosis, one of which, CDX2, was stage independent. Three among gastric and pancreatobiliary duct markers (MUC1, MUC6, and pepsinogen II), predicted more severe prognosis stage independently, as did a combination of eight potentially informative (p < 0.1 at univariable Cox analysis) markers. Cancers with predominantly intestinal phenotype had significantly better prognosis than those with predominantly gastric, mixed, or poorly defined phenotypes; among the latter, those with high lymphocyte response, with favorable outcome, were separated from anaplastic cancers, with ominous prognosis. At multivariable analysis, CDX2 and the eight marker combination proved to be stage- and grade-independent predictors.
  
  
  CONCLUSIONS
  When individually considered, and with the exception of CDX2, the biomarkers investigated gave an appreciable, although moderate, contribution to the prognostic evaluation of gastric cancer. Combined analysis of all potentially informative markers gave more important information, highly additive to both stage and histotype-based grade.
authors: Department of Pathology, University of Pavia, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, 27100, Pavia, Italy.
authors: Enrico
authors: E
authors: Solcia
authors: Catherine
authors: C
authors: Klersy
authors: Alessandro
authors: A
authors: Vanoli
authors: Federica
authors: F
authors: Grillo
authors: Rachele
authors: R
authors: Manca
authors: Francesca
authors: F
authors: Tava
authors: Ombretta
authors: O
authors: Luinetti
authors: Roberto
authors: R
authors: Fiocca
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism*; D005500:Follow-Up Studies; D005753:Gastric Mucosa / Q000378:metabolism*; D006801:Humans; D007124:Immunoenzyme Techniques; D009367:Neoplasm Staging; D010641:Phenotype; D011379:Prognosis; D013274:Stomach Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology*; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor