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Arakawa N, Irisawa A, Ishida K, Tsunoda T, Yamaguchi Y, Shibukawa G, Eizuka M, Tokioka S, Wakabayashi H. Clinical Differences in c-Myc Expression in Early-Stage Gastric Neoplasia: A Retrospective Study Based on the WHO Classification. J Clin Med 2022; 11:544. [PMID: 35159995 PMCID: PMC8836573 DOI: 10.3390/jcm11030544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/12/2022] [Accepted: 01/20/2022] [Indexed: 02/01/2023] Open
Abstract
c-Myc is an oncogene that is dysregulated in various cancers. Early gastric neoplasia with c-Myc expression has been reported as a more malignant lesion. This study clarifies the differences in c-Myc expression in early gastric neoplasia based on the WHO classification. Samples from 100 patients with differentiated-type early gastric neoplasia, who underwent endoscopic submucosal dissection between March 2020 and January 2021, were stained for c-Myc. One hundred lesions were classified as low-grade dysplasia, high-grade dysplasia, or intramucosal adenocarcinoma. The staining intensity and extent were scored. A hierarchical cluster analysis for a clinicopathological analysis among the groups, the chi-square test, Bonferroni correction, and residual analysis were performed. Subgroup one and two consisted of 39 patients; while subgroup three consisted of 22. Significant differences among various characteristics were observed between these subgroups. The frequency of low-grade dysplasia was significantly higher, while that of high-grade dysplasia was significantly lower in subgroup three. The frequency of intramucosal adenocarcinoma was significantly higher in subgroup one. The c-Myc positivity rate was significantly higher in subgroup one compared with that in subgroup three. c-Myc expression distinctly differed in early gastric neoplasia. c-Myc-negative low-grade dysplasia may be separately categorized from c-Myc-positive low-grade dysplasia, high-grade dysplasia, and intramucosal adenocarcinoma.
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Affiliation(s)
- Noriyuki Arakawa
- Department of Gastroenterology, Takeda General Hospital, Aizuwakamatsu 965-8585, Japan; (T.T.); (S.T.); (H.W.)
| | - Atsushi Irisawa
- Department of Gastroenterology, Dokkyo Medical University School of Medicine, Mibu 321-0293, Japan;
| | - Kazuyuki Ishida
- Department of Pathology, Dokkyo Medical University School of Medicine, Mibu 321-0293, Japan;
| | - Takuya Tsunoda
- Department of Gastroenterology, Takeda General Hospital, Aizuwakamatsu 965-8585, Japan; (T.T.); (S.T.); (H.W.)
| | - Yoshiko Yamaguchi
- Department of Pathology, Takeda General Hospital, Aizuwakamatsu 965-8585, Japan;
| | - Goro Shibukawa
- Department of Gastroenterology, Aizu Medical Center, Fukushima Medical University, Aizuwakamatsu 969-3492, Japan;
| | - Makoto Eizuka
- Department of Molecular Diagnostic Pathology, Iwate Medical University School of Medicine, Iwate 028-3694, Japan;
| | - Shunzo Tokioka
- Department of Gastroenterology, Takeda General Hospital, Aizuwakamatsu 965-8585, Japan; (T.T.); (S.T.); (H.W.)
| | - Hiroto Wakabayashi
- Department of Gastroenterology, Takeda General Hospital, Aizuwakamatsu 965-8585, Japan; (T.T.); (S.T.); (H.W.)
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Lee J, Lee IS, Ahn JY, Park YS, Kim J. Extremely well-differentiated adenocarcinoma of the stomach: diagnostic pitfalls in endoscopic biopsy. J Pathol Transl Med 2021; 56:63-72. [PMID: 34775732 PMCID: PMC8935003 DOI: 10.4132/jptm.2021.10.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/12/2021] [Indexed: 11/17/2022] Open
Abstract
Background Extremely well-differentiated adenocarcinoma (EWDA) is a deceptively bland-looking adenocarcinoma of the stomach. It often causes diagnostic problems, especially in endoscopic biopsy samples. To better recognize this deceptively bland lesion, we carefully reviewed a series of EWDAs treated at our institution. Methods A total of 55 specimens from 19 patients were obtained. Endoscopic, gross and microscopic features defining EWDA were described and documented. For comparison, hyperplastic polyp specimens were randomly selected and analyzed. Results Most cases (18 of 19, 94.7%) were advanced gastric cancer (AGC) and primarily located in the body of the stomach (15 of 19, 79.0%). The majority of AGCs were non-ulcerated (11 of 18, 61.1%) with an undermining growth pattern and a relatively small mucosal involvement. Specific histologic features included an irregular glandular shape, an undulating apical cytoplasmic border, disproportionately large glands, a variably distended mucinous cytoplasm. Classical features, such as small infiltrating glands or desmoplastic reactions, were barely observed. Identification of irregularly spaced nuclei and disruption of the foveolar epithelial structure, along with atypical features described above were helpful in making a diagnosis especially in gastric forceps biopsies. Conclusions Awareness of the histomorphologic characteristics described in this report would lead to timely diagnosis and prevent repeated endoscopic procedures.
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Affiliation(s)
- Jongwon Lee
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - In-Seob Lee
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji Yong Ahn
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Soo Park
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jihun Kim
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Kang JU. Chromosome 8q as the most frequent target for amplification in early gastric carcinoma. Oncol Lett 2014; 7:1139-1143. [PMID: 24944681 PMCID: PMC3961457 DOI: 10.3892/ol.2014.1849] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Accepted: 01/15/2014] [Indexed: 12/12/2022] Open
Abstract
Early gastric carcinoma (GC) is considered to be a curable cancer, as it progresses to the advanced stage following varying durations. Understanding the early stage of GC may provide an insight into its pathogenesis and contribute to reducing the mortality rate of this disease. To investigate the genomic aberrations associated with 22 cases of early GC, high-density microarray comparative genomic hybridization was performed in the present study. The most notable finding was copy number gains (log2 ratio >0.25) on the long arm of chromosome 8, which occurred in 77.3% (17/22) of GC cases, and the delineated minimal common region was 8q22.1-q24.3. More specifically, two amplified (log2 ratio >1) loci in the 8q22.1-q24.3 region were detected in 18.2% (4/22) of GC cases. The first loci covered a region of 102.4–107.9 kb, mapping on 8q22.3-q23.1, and comprised the transcription factor CP2-like 3 gene. The second loci, spanning 128.7–145.7 kb on 8q24.21-q24.3, comprised the representative oncogene of myelocytomatosis. Furthermore, the following possible target genes that were not previously considered to play a pathogenic role in GC were identified: Plasmacytoma variant translocation 1, cysteine/histidine rich 1, kinesin family member C2, forkhead box H1, protein phosphatase 1 regulatory subunit 16A, glutamic-pyruvate transaminase, LOC113655 and RecQ protein-like 4. In the present study, previous findings showing that 8q mutations accumulate early during the multistage pathogenesis of GC were confirmed and expanded upon. The confirmation of previously reported 8q gains and the identification of novel target genes at 8q22.1-q24.3 amplified chromosomal sites should aid in improving our understanding of the molecular mechanisms underlying the tumorigenesis of early GC.
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Affiliation(s)
- Ji Un Kang
- Department of Biomedical Laboratory Science, Korea Nazarene University, Cheonan 330-718, Republic of Korea
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Sonoda A, Mukaisho KI, Nakayama T, Diem VTN, Hattori T, Andoh A, Fujiyama Y, Sugihara H. Genetic lineages of undifferentiated-type gastric carcinomas analysed by unsupervised clustering of genomic DNA microarray data. BMC Med Genomics 2013; 6:25. [PMID: 23866769 PMCID: PMC3728264 DOI: 10.1186/1755-8794-6-25] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Accepted: 07/11/2013] [Indexed: 12/13/2022] Open
Abstract
Background It is suspected that early gastric carcinoma (GC) is a dormant variant that rarely progresses to advanced GC. We demonstrated that the dormant and aggressive variants of tubular adenocarcinomas (TUBs) of the stomach are characterized by loss of MYC and gain of TP53 and gain of MYC and/or loss of TP53, respectively. The aim of this study is to determine whether this is also the case in undifferentiated-type GCs (UGCs) of different genetic lineages: one with a layered structure (LS+), derived from early signet ring cell carcinomas (SIGs), and the other, mostly poorly differentiated adenocarcinomas, without LS but with a minor tubular component (TC), dedifferentiated from TUBs (LS−/TC+). Methods Using 29 surgically resected stomachs with 9 intramucosal and 20 invasive UGCs (11 LS+ and 9 LS−/TC+), 63 genomic DNA samples of mucosal and invasive parts and corresponding reference DNAs were prepared from formalin-fixed, paraffin-embedded tissues with laser microdissection, and were subjected to array-based comparative genomic hybridization (aCGH), using 60K microarrays, and subsequent unsupervised, hierarchical clustering. Of 979 cancer-related genes assessed, we selected genes with mean copy numbers significantly different between the two major clusters. Results Based on similarity in genomic copy-number profile, the 63 samples were classified into two major clusters. Clusters A and B, which were rich in LS+ UGC and LS−/TC+ UGC, respectively, were discriminated on the basis of 40 genes. The aggressive pattern was more frequently detected in LS−/TC+ UGCs, (20/26; 77%), than in LS+UGCs (17/37; 46%; P = 0.0195), whereas no dormant pattern was detected in any of the UGC samples. Conclusions In contrast to TUBs, copy number alterations of MYC and TP53 exhibited an aggressive pattern in LS+ SIG at early and advanced stages, indicating that early LS+ UGCs inevitably progress to an advanced GC. Cluster B (enriched in LS−/TC+) exhibited more frequent gain of driver genes and a more frequent aggressive pattern than cluster A, suggesting potentially worse prognosis in UGCs of cluster B.
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Affiliation(s)
- Ayano Sonoda
- Department of Pathology, Division of Molecular and Diagnostic Pathology, Shiga University of Medical Science, Otsu 520-2192, Japan
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Kuroda A, Tsukamoto Y, Nguyen LT, Noguchi T, Takeuchi I, Uchida M, Uchida T, Hijiya N, Nakada C, Okimoto T, Kodama M, Murakami K, Matsuura K, Seto M, Ito H, Fujioka T, Moriyama M. Genomic profiling of submucosal-invasive gastric cancer by array-based comparative genomic hybridization. PLoS One 2011; 6:e22313. [PMID: 21811585 PMCID: PMC3141024 DOI: 10.1371/journal.pone.0022313] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2011] [Accepted: 06/19/2011] [Indexed: 12/28/2022] Open
Abstract
Genomic copy number aberrations (CNAs) in gastric cancer have already been extensively characterized by array comparative genomic hybridization (array CGH) analysis. However, involvement of genomic CNAs in the process of submucosal invasion and lymph node metastasis in early gastric cancer is still poorly understood. In this study, to address this issue, we collected a total of 59 tumor samples from 27 patients with submucosal-invasive gastric cancers (SMGC), analyzed their genomic profiles by array CGH, and compared them between paired samples of mucosal (MU) and submucosal (SM) invasion (23 pairs), and SM invasion and lymph node (LN) metastasis (9 pairs). Initially, we hypothesized that acquisition of specific CNA(s) is important for these processes. However, we observed no significant difference in the number of genomic CNAs between paired MU and SM, and between paired SM and LN. Furthermore, we were unable to find any CNAs specifically associated with SM invasion or LN metastasis. Among the 23 cases analyzed, 15 had some similar pattern of genomic profiling between SM and MU. Interestingly, 13 of the 15 cases also showed some differences in genomic profiles. These results suggest that the majority of SMGCs are composed of heterogeneous subpopulations derived from the same clonal origin. Comparison of genomic CNAs between SMGCs with and without LN metastasis revealed that gain of 11q13, 11q14, 11q22, 14q32 and amplification of 17q21 were more frequent in metastatic SMGCs, suggesting that these CNAs are related to LN metastasis of early gastric cancer. In conclusion, our data suggest that generation of genetically distinct subclones, rather than acquisition of specific CNA at MU, is integral to the process of submucosal invasion, and that subclones that acquire gain of 11q13, 11q14, 11q22, 14q32 or amplification of 17q21 are likely to become metastatic.
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Affiliation(s)
- Akiko Kuroda
- Department of Molecular Pathology, Faculty of Medicine, Oita University, Oita, Japan
- Department of General Medicine, Faculty of Medicine, Oita University, Oita, Japan
| | - Yoshiyuki Tsukamoto
- Department of Molecular Pathology, Faculty of Medicine, Oita University, Oita, Japan
- * E-mail:
| | - Lam Tung Nguyen
- Department of Molecular Pathology, Faculty of Medicine, Oita University, Oita, Japan
- Department of General Medicine, Faculty of Medicine, Oita University, Oita, Japan
| | - Tsuyoshi Noguchi
- Department of Gastrointestinal Surgery, Faculty of Medicine, Oita University, Oita, Japan
| | - Ichiro Takeuchi
- Department of Computer Science/Scientific and Engineering Simulation, Nagoya Institute of Technology, Nagoya, Japan
| | - Masahiro Uchida
- Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan
| | - Tomohisa Uchida
- Department of Molecular Pathology, Faculty of Medicine, Oita University, Oita, Japan
| | - Naoki Hijiya
- Department of Molecular Pathology, Faculty of Medicine, Oita University, Oita, Japan
| | - Chisato Nakada
- Department of Molecular Pathology, Faculty of Medicine, Oita University, Oita, Japan
| | - Tadayoshi Okimoto
- Department of General Medicine, Faculty of Medicine, Oita University, Oita, Japan
- Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan
| | - Masaaki Kodama
- Department of General Medicine, Faculty of Medicine, Oita University, Oita, Japan
- Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan
| | - Kazunari Murakami
- Department of General Medicine, Faculty of Medicine, Oita University, Oita, Japan
- Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan
| | - Keiko Matsuura
- Department of Molecular Pathology, Faculty of Medicine, Oita University, Oita, Japan
| | - Masao Seto
- Division of Molecular Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Hisao Ito
- Division of Organ Pathology, Department of Microbiology and Pathology, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Toshio Fujioka
- Department of General Medicine, Faculty of Medicine, Oita University, Oita, Japan
- Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan
| | - Masatsugu Moriyama
- Department of Molecular Pathology, Faculty of Medicine, Oita University, Oita, Japan
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