title: Inducible nitric oxide synthase expression in gastric adenocarcinoma: impact on lymphangiogenesis and lymphatic metastasis.
abstract: BACKGROUND
  Lymphatic metastasis is the most important parameter in the spread of gastric carcinomas. Nitric oxide (NO) is a signaling molecule that plays an important role in inflammation and carcinogenesis. In this study, the possible link between inducible nitric oxide synthase (iNOS) expression with lymphangiogenesis and the clinicopathological parameters of gastric carcinomas was investigated.
  
  
  METHODS
  In this study, iNOS expression and D2-40 (lymphatic endothelium-specific marker monoclonal antibody) reactivity were examined immunohistochemically in 41 gastric adenocarcinoma and 20 non-neoplastic gastric tissues. iNOS expression was scored semiquantitatively in the tumor parenchyma and stroma. D2-40-positive lymphatic vessels were used in the determination of lymphatic invasion and intratumoral and peritumoral lymphatic vascular density.
  
  
  RESULTS
  iNOS expression was higher in gastric carcinoma tissue compared with non-neoplastic tissue. Particularly, iNOS expression in tumor cells was found to be closely related to lymphangiogenesis and lymphatic metastasis. The density of lymphatic invasion as well as intratumoral and peritumoral lymphatic vascular density were positively correlated with lymph node metastasis.
  
  
  CONCLUSIONS
  Our results suggest that iNOS-mediated NO formation plays an important role in gastric carcinogenesis, tumor lymphangiogenesis, and the development of lymphatic metastases. Inhibition of the NO pathway may be an alternative treatment of gastric carcinomas.
  The virtual slides for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1713572940104388.
authors.affiliation: Department of Pathology, Faculty of Medicine, Bulent Ecevit University, Zonguldak, Turkey. niluferkandemir@yahoo.com.
authors.forename: Nimet
authors.initials: N
authors.lastname: Karadayı
authors.forename: Nilufer Onak
authors.initials: NO
authors.lastname: Kandemır
authors.forename: Dilek
authors.initials: D
authors.lastname: Yavuzer
authors.forename: Taner
authors.initials: T
authors.lastname: Korkmaz
authors.forename: Gonca
authors.initials: G
authors.lastname: Gecmen
authors.forename: Furuzan
authors.initials: F
authors.lastname: Kokturk
mesh_terms: D000230:Adenocarcinoma / Q000201:enzymology* / Q000556:secondary* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived; D014408:Biomarkers, Tumor / Q000032:analysis*; D016022:Case-Control Studies; D005260:Female; D005743:Gastrectomy; D006801:Humans; D007150:Immunohistochemistry; D008197:Lymph Node Excision; D042583:Lymphangiogenesis; D008207:Lymphatic Metastasis; D042601:Lymphatic Vessels / Q000737:chemistry / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D052247:Nitric Oxide Synthase Type II / Q000032:analysis*; D013274:Stomach Neoplasms / Q000201:enzymology* / Q000473:pathology* / Q000601:surgery
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D014408:Biomarkers, Tumor; C500987:monoclonal antibody D2-40; C496319:NOS2 protein, human; D052247:Nitric Oxide Synthase Type II
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