Clinicopathological and Molecular Findings of Differentiated-Type Minute Gastric Intramucosal Neoplasia

Digestion. 2020;101(3):287-297. doi: 10.1159/000499464. Epub 2019 Apr 3.

Abstract

Background/aims: To evaluate gastric early differentiate-type carcinogenesis, we attempted to identify clinicopathological and biological differences in differentiated-type minute intramucosal neoplasia (MIMN), which was defined as a tumor with a diameter of < 5 mm.

Methods: We examined clinicopathological findings and biological factors, including TP53 overexpression, mucin phenotype, Ki-67-positive rate, MLH1, intranuclear accumulation of β-catenin, and DNA methylation status (low methylation epigenotype [LME], intermediate methylation epigenotype, and high methylation epigenotype [HME]) in MIMNs. In addition, non-MIMNs were also analyzed. In the present study, MIMN and non-MIMN were also examined based on low-grade dysplasia, high-grade dysplasia, and intramucosal cancer (IMC).

Results: In clinicopathological findings, there were significant differences in sex ratios and tumor locations between MIMNs and non-MIMNs. Among the examined biological factors, no significant differences in the frequencies of biological factors were observed between the 2 intramucosal neoplasia types. However, the frequency of intranuclear accumulation of β-catenin was higher in non-MIMNs than in MIMNs. Finally, although the frequency of HME was significantly lower in MIMNs than in non-MIMNs, the opposite was observed for LME.

Conclusions: The current finding suggested that DNA methylation and accumulation of β-catenin were closely associated with tumor development from MIMN to non-MIMN.

Keywords: DNA methylation; Intramucosal neoplasia; Minute gastric cancer; Mucin phenotype; β-Catenin.

MeSH terms

  • Adenocarcinoma / epidemiology
  • Adenocarcinoma / genetics
  • Adenocarcinoma / pathology*
  • Adenocarcinoma / surgery
  • Aged
  • Aged, 80 and over
  • Carcinogenesis / genetics
  • Carcinogenesis / pathology*
  • Cell Differentiation
  • Cell Nucleus / metabolism
  • DNA Methylation
  • Endoscopic Mucosal Resection
  • Female
  • Gastric Mucosa / cytology
  • Gastric Mucosa / pathology*
  • Gastric Mucosa / surgery
  • Humans
  • Male
  • Middle Aged
  • Precancerous Conditions / genetics
  • Precancerous Conditions / pathology*
  • Precancerous Conditions / surgery
  • Risk Factors
  • Sex Factors
  • Stomach Neoplasms / epidemiology
  • Stomach Neoplasms / genetics
  • Stomach Neoplasms / pathology*
  • Stomach Neoplasms / surgery
  • beta Catenin / analysis
  • beta Catenin / metabolism

Substances

  • CTNNB1 protein, human
  • beta Catenin