Journal article

Mucin expression in gastric- and gastro-oesophageal signet-ring cell cancer: results from a comprehensive literature review and a large cohort study of Caucasian and Asian gastric cancer.

  • Kerckhoffs KGP Department of Pathology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, P. Debyelaan 25, 6229HX, Maastricht, The Netherlands.
  • Liu DHW Department of Pathology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, P. Debyelaan 25, 6229HX, Maastricht, The Netherlands.
  • Saragoni L Pathology Unit, Morgagni-Pierantoni Hospital, Forlì, Italy.
  • van der Post RS Department of Pathology, Radboudumc, Nijmegen, The Netherlands.
  • Langer R Institute of Pathology, University of Bern, Bern, Switzerland.
  • Bencivenga M Unit of General and Upper GI Surgery , University of Verona, Verona, Italy.
  • Iglesias M Pathology Department, Hospital del Mar, Universitat Autonoma de Barcelona, Barcelona, Spain.
  • Gallo G Department of Anatomic Pathology, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, Italy.
  • Hewitt LC Department of Pathology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, P. Debyelaan 25, 6229HX, Maastricht, The Netherlands.
  • Fazzi GE Department of Pathology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, P. Debyelaan 25, 6229HX, Maastricht, The Netherlands.
  • Vos AM Department of Pathology, Radboudumc, Nijmegen, The Netherlands.
  • Renaud F Department of Pathology, Univ. Lille, CNRS, Inserm, CHU Lille, UMR9020 - UMR-S 1277 - Canther - Cancer Heterogeneity, Plasticity and Resistance to Therapies, Lille, France.
  • Yoshikawa T Department of Gastric Surgery, National Cancer Center Hospital, Tokyo, Japan.
  • Oshima T Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan.
  • Tomezzoli A Department of Pathology, Verona University Hospital, Verona, Italy.
  • de Manzoni G Unit of General and Upper GI Surgery , University of Verona, Verona, Italy.
  • Arai T Department of Pathology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan.
  • Kushima R Department of Pathology, Shiga University of Medical Science, Shiga, Japan.
  • Carneiro F Institute of Molecular Pathology and Immunology at the University of Porto (Ipatimup), Porto, Portugal.
  • Grabsch HI Department of Pathology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, P. Debyelaan 25, 6229HX, Maastricht, The Netherlands. h.grabsch@maastrichtuniversity.nl.
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  • 2020-06-04
Published in:
  • Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association. - 2020
English BACKGROUND
The literature on the prognostic relevance of signet-ring cell (SRC) histology in gastric cancer (GC) is controversial which is most likely related to inconsistent SRC classification based on haematoxylin-eosin staining. We hypothesised that mucin stains can consistently identify SRC-GC and predict GC patient outcome.


METHODS
We performed a comprehensive literature review on mucin stains in SRC-GC and characterised the mucin expression in 851 Caucasian GC and 410 Asian GC using Alcian Blue (AB)-Periodic Acid-Schiff (PAS), MUC2 (intestinal-type mucin), and MUC5AC (gastric-type mucin). The relationship between mucin expression and histological phenotype [poorly cohesive (PC) including proportion of SRCs, non-poorly cohesive (non-PC), or mucinous (MC)], clinicopathological variables, and patient outcome was analysed.


RESULTS
Depending on mucin expression and cut-offs, the positivity rates of SRC-GC reported in the literature varied from 6 to 100%. Patients with MUC2 positive SRC-GC or SRC-GC with (gastro)intestinal phenotype had poorest outcome. In our cohort study, PC with ≥ 10% SRCs expressed more frequently MUC2, MUC5AC, and ABPAS (p < 0.001, p = 0.004 and p < 0.001, respectively). Caucasians with AB positive GC or combined ABPAS-MUC2 positive and MUC5AC negative had poorest outcome (all p = 0.002). This association was not seen in Asian patients.


CONCLUSIONS
This is the first study to suggest that mucin stains do not help to differentiate between SRC-GC and non-SRC-GC. However, mucin stains appear to be able to identify GC patients with different outcome. To our surprise, the relationship between outcome and mucin expression seems to differ between Caucasian and Asian GC patients which warrants further investigations.
Language
  • English
Open access status
hybrid
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Persistent URL
https://sonar.ch/global/documents/122302
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