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2015 ; 94
(42
): e1810
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New Insights in Histogenetic Pathways of Gastric Cancer
#MMPMID26496316
Gurzu S
; Sugimura H
; Orlowska J
; Szentirmay Z
; Jung I
Medicine (Baltimore)
2015[Oct]; 94
(42
): e1810
PMID26496316
show ga
The aim of this paper was to describe 3 possible histogenetic pathways for poorly
cohesive (diffuse) carcinomas and 2 for intestinal-type gastric carcinomas (GCs),
which might influence the behavior of GC. In the present observational study, 102
patients with early (n = 50) and advanced GCs (n = 52) were evaluated, and the
histogenetic background was analyzed. All of the cases were sporadic GCs. For
particular aspects, Maspin, E-cadherin, and SLUG immunostains were performed. For
our final conclusions, the results were correlated with literature data. In early
stages, poorly cohesive carcinomas can display 3 histogenetic pathways, with
particular molecular behaviors: "carcinoma with intraepithelial pagetoid onset"
(with or without a switch from E-cadherin to SLUG positivity), "carcinoma with
early lymphatic invasion" (carcinoma limited to mucosa but with carcinomatosis of
the lymph vessels from subjacent layers), and "microglandular-type poorly
cohesive carcinoma" (the onset is similar with adenocarcinoma but abrupt
dedifferentiation can be seen in the submucosa, with persistence of a dual
component in the deep layers). The intestinal type carcinoma can be developed on
the background of superficially located dysplasia ("classic adenocarcinoma") or
in the submucosal heterotopic mucosa ("adenocarcinoma arising from the mucosal
infolding in the submucosa"). Based on personal observations correlated with
literature data, 5 histopathogenetic pathways are proposed with specific
denominations. Each of them can partially explain the aberrant behavior of early
gastric cancer.