Analysis of mucin, p53 protein and Ki-67 expressions in gastric differentiated-type intramucosal neoplastic lesions obtained from endoscopic mucosal resection samples: a proposal for a new classification of intramucosal neoplastic lesions based on nuclear atypia

Pathol Int. 2004 Jun;54(6):425-35. doi: 10.1111/j.1440-1827.2004.01643.x.

Abstract

There are differing views between Western and Japanese pathologists on the use of histological criteria to classify gastrointestinal tumors. It is therefore a priority to create a new histological classification of the stomach in order to resolve the confusion. Expression patterns were examined of mucin (MUC2, CD10, MUC5AC, pyloric gland-type mucin), p53 protein, and Ki-67 in tumor cells according to the following new classification system for differentiated-type intramucosal neoplastic lesions of the stomach, based on nuclear atypia: borderline neoplasia (adenoma (including dysplasia), indefinite tumor of adenoma or low-grade cancer, and low-grade cancer) and definite carcinoma (intermediate cancer, and high-grade cancer). The resulting grades were: adenoma, 23; indefinite tumor for adenoma or low-grade cancer, 6; low-grade cancer, 28; intermediate cancer, 48; high-grade cancer, 20. While the frequency of intestinal-type borderline neoplasias was higher than that of definite carcinomas, the mixed-type of definite carcinomas occurred with higher frequency than borderline neoplasias. The p53 protein overexpression and the Ki-67-positive rate increased with an increase in the grade assigned according to the new classification. The correlated expression levels of p53 protein, Ki-67, and various mucins, support the conclusion that this classification of intramucosal neoplastic lesions is useful for obtaining a consensus diagnosis of gastric intramucosal neoplasia between pathologists and gastrointestinal clinicians.

MeSH terms

  • Adenocarcinoma / classification
  • Adenocarcinoma / metabolism*
  • Adenocarcinoma / pathology
  • Adenoma / classification
  • Adenoma / metabolism*
  • Adenoma / pathology
  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / metabolism
  • Female
  • Gastric Mucins / metabolism*
  • Gastric Mucosa / metabolism
  • Gastric Mucosa / pathology
  • Gastric Mucosa / surgery
  • Gastroscopy
  • Humans
  • Ki-67 Antigen / metabolism*
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Stomach Neoplasms / classification
  • Stomach Neoplasms / metabolism*
  • Stomach Neoplasms / pathology
  • Tumor Suppressor Protein p53 / metabolism*

Substances

  • Biomarkers, Tumor
  • Gastric Mucins
  • Ki-67 Antigen
  • Tumor Suppressor Protein p53