Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2007 Jun;60(6):615-21.
doi: 10.1136/jcp.2006.040386.

Indefinite for non-invasive neoplasia lesions in gastric intestinal metaplasia: the immunophenotype

Mauro Cassaro  1 , Massimo Rugge, Chiara Tieppo, Luciano Giacomelli, Daniela Velo, Donato Nitti, Fabio Farinati
Affiliations

Indefinite for non-invasive neoplasia lesions in gastric intestinal metaplasia: the immunophenotype

Mauro Cassaro et al. J Clin Pathol. 2007 Jun.

Abstract

Background: In the Padova International Classification, gastric precancerous lesions are labelled as "indefinite for non-invasive neoplasia" (Indef-NiN) cytohistological alterations mimicking non-invasive neoplasia (NiN), but lacking all the attributes required for a definite NiN categorisation.

Aim: To apply a panel of immunohistochemical (IHC) markers of cell proliferation (Mib1), intestinal differentiation (Cdx2), apoptosis (pro-caspase 3) and cell immortalisation (hTERT) to compare the IHC profiles of a series of precancerous lesions arising in gastric intestinalised (ie, IM-positive) glands.

Materials and methods: By applying the histological criteria consistently provided by both the Padova Classification and the World Health Organization International Agency, 112 consecutive cases were considered: intestinal metaplasia (IM; n = 54), Indef-NiN in IM-positive gastric glands (n = 28) and low-grade (LG) NiN (n = 30). In each histological category, the expression of the marker was separately scored in superficial, proliferative and coil compartments.

Results: In all glandular compartments, Mib1, Cdx2, hTERT and pro-caspase 3 were consistently more expressed in LG-NiN than in either IM or Indef-NiN lesions (analysis of variance: p<0.001). Significant ORs (calculated by ordinal logistic regression analysis for each glandular compartment) associated IM, Indef-NiN and LG-NiN with the expression of the considered markers.

Conclusions: A consistent overexpression (unrestricted to the proliferative zone) of IHC markers of cell proliferation, intestinal differentiation, decreased apoptosis and cell immortalisation differentiates LG-NiN from both (simple) IM and Indef-NiN (arising in IM). An increased proliferative activity in the proliferative zone discriminates Indef-NiN lesions (ie, hyperproliferative IM) from IM. Such divergent IHC profiles may provide a rationale for scheduling follow-up protocols more properly tailored on the patient's risk for cancer.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

References

    1. Fenoglio‐Preiser C, Carneiro F, Correa P.et al Gastric carcinoma. In: Hamilton SR, Aaltonen LA, eds. Pathology and genetics, tumors of the digestive system. Lyon, France: IARC Press, 200039–52.
    1. Rugge M, Correa P, Dixon M F.et al Gastric dysplasia: the Padova International Classification. Am J Surg Pathol 200024167–176. - PubMed
    1. Rugge M, Leandro G, Farinati F.et al Gastric epithelial dysplasia. How clinicopathologic background relates to management. Cancer 199576376–382. - PubMed
    1. Rugge M, Farinati F, Baffa R.et al Gastric epithelial dysplasia in the natural history of gastric cancer: a multicenter prospective follow‐up study. Interdisciplinary Group on Gastric Epithelial Dysplasia. Gastroenterology 19941071288–1296. - PubMed
    1. Rugge M, Cassaro M, Di Mario F.et al The long term outcome of gastric non‐invasive neoplasia. Gut 2003521111–1116. - PMC - PubMed

Publication types

MeSH terms