Clinicopathological and Immunohistochemical Characteristics of Super-minute Gastric Adenocarcinomas Yasuko Fujita 1 , Noriyuki Uesugi 1 , Mitsuo Kishimoto 2 , Noriyuki Yamada 1 , Makoto Eizuka 1 , Ryo Sugimoto 1 , Keisuke Kawasaki 3 , Takayuki Matsumoto 3 , Osamu Dohi 4 , Kazuhiro Kamada 4 , Yuji Naito 4 , Akio Yanagisawa 2,5 , Tamotsu Sugai 1 1Department of Molecular Diagnostic Pathology, School of Medicine, Iwate Medical University, Morioka, Japan 2Department of Surgical Pathology, Kyoto Prefectural University of Medicine, Kyoto, Japan 3Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Morioka, Japan 4Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan 5Department of Pathology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan Keyword: 超微小胃癌 , 微小胃癌 , 粘液形質 , 腫瘍グレード , p53過剰発現 pp.1502-1514
Published Date 2018/10/25
DOI https://doi.org/10.11477/mf.1403201500
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 Background and aims:This study aimed to clarify the clinicopathological and immunohistochemical characteristics of SMCs(super-minute gastric cancers)(diameter, ≦1mm)as the earliest gastric cancer that can be investigated.

 Material and methods:Twenty-four SMC lesions and 35 MC(minute gastric cancer)lesions(diameter, >1mm and ≦5mm, respectively)as well as 101 NMC(non-minute gastric cancer)lesions(diameter, >5mm)resected by endoscopy were examined. We investigated their clinicopathological characteristics and performed immunohistochemical analyses to assess mucin phenotype, CDX2, p53, beta-catenin, and MLH-1.

 Results:Immunohistochemically, most SMCs demonstrated significant overexpression of p53. Contrarily, nuclear accumulation of beta-catenin was statistically significant in NMCs. Loss of MHL-1 expression was not statistically significant among the three groups.

 Conclusions:SMCs may differ from MCs and NMCs in terms of an abnormal p53 pathway. Moreover, aberrations in the Wnt pathway are accumulated during tumor progression, and abnormalities of mismatch repair genes occur in the early phase of cancer development.

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