Immunohistochemical consistency between primary tumors and lymph node metastases of gastric neuroendocrine carcinoma

Uchiyama Chieko, Tamura Shigeyuki, Nakatsuka Shinichi, Takeno Atsushi, Miki Hirofumi, Kanemura Takashi, Nakahira Shin, Suzuki Rei, Nakata Ken, Takeda Yutaka, Kato Takeshi

Description

Gastric neuroendocrine carcinoma (G-NEC) is a rare, highly malignant tumor that exhibits aggressive growth leading to vascular invasion, distant metastasis and extremely poor prognosis. We studied the clinicopathological findings of seven patients at our institute to better under this disease. Methods Seven cases of G-NEC were identified among 1,027 cases of gastric carcinoma that underwent gastrectomy at Kansai Rousai Hospital between 2002 and 2010. We studied the pathological and immunohistochemical features of gastric neuroendocrine carcinomas at both the primary site and metastatic lymph nodes. Results The mean patient age was 73 years (range 63 to 86 years). There were no females in this series. The final staging was Stage I in one case, Stage II in two, Stage III in two and Stage IV in two. A total of 31 metastatic lymph nodes were found in these patients. This study revealed that the ratio of neuroendocrine cells was similar between the primary and metastatic sites, which tended to show the same expression patterns of neuroendocrine markers. Conclusions Metastatic lymph nodes showed heterogeneous immunohistochemical expression patterns similar to the primary sites. G-NEC is far advanced at diagnosis and rapidly reaches the lymph nodes retaining its heterogeneity, carrying a worse prognosis than common gastric cancer. Mini abstract G-NEC grows rapidly and metastasizes to the lymph nodes, retaining its pathological and immunohistochemical heterogeneity even at the metastatic sites.

Sujets

• Ki-67 (protein)
• Immunohistochemistry
• Homogeneity and heterogeneity

Informations

• Publié par: biomed
• Publié le: 01 janvier 2012
• Nombre de lectures: 6
• Langue: English
• Poids de l'ouvrage: 1 Mo

Extrait

Uchiyamaet al. World Journal of Surgical Oncology2012,10:115 http://www.wjso.com/content/10/1/115

WORLD JOURNAL OF SURGICAL ONCOLOGY

R E S E A R C HOpen Access Immunohistochemical consistency between primary tumors and lymph node metastases of gastric neuroendocrine carcinoma 1 1*2 11 1 Chieko Uchiyama , Shigeyuki Tamura, Shinichi Nakatsuka , Atsushi Takeno , Hirofumi Miki , Takashi Kanemura , 1 11 11 Shin Nakahira , Rei Suzuki , Ken Nakata , Yutaka Takedaand Takeshi Kato

Abstract Background:Gastric neuroendocrine carcinoma (GNEC) is a rare, highly malignant tumor that exhibits aggressive growth leading to vascular invasion, distant metastasis and extremely poor prognosis. We studied the clinicopathological findings of seven patients at our institute to better under this disease. Methods:Seven cases of GNEC were identified among 1,027 cases of gastric carcinoma that underwent gastrectomy at Kansai Rousai Hospital between 2002 and 2010. We studied the pathological and immunohistochemical features of gastric neuroendocrine carcinomas at both the primary site and metastatic lymph nodes. Results:The mean patient age was 73 years (range 63 to 86 years). There were no females in this series. The final staging was Stage I in one case, Stage II in two, Stage III in two and Stage IV in two. A total of 31 metastatic lymph nodes were found in these patients. This study revealed that the ratio of neuroendocrine cells was similar between the primary and metastatic sites, which tended to show the same expression patterns of neuroendocrine markers. Conclusions:Metastatic lymph nodes showed heterogeneous immunohistochemical expression patterns similar to the primary sites. GNEC is far advanced at diagnosis and rapidly reaches the lymph nodes retaining its heterogeneity, carrying a worse prognosis than common gastric cancer. Mini abstract:GNEC grows rapidly and metastasizes to the lymph nodes, retaining its pathological and immunohistochemical heterogeneity even at the metastatic sites. Keywords:Ki67, Immunohistochemistry, Heterogeneity

Background Gastric neuroendocrine carcinoma (GNEC) is a rare tumor (0.1 to 0.2% of all gastric carcinomas) with highly malignant biological behavior exhibiting aggressive growth that leads to vascular invasion, distant metastasis and extremely poor prognosis. The 2010 WHO classifi cation defines welldifferentiated endocrine tumors/car cinomas as neuroendocrine tumors (NETs), and poorly differentiated endocrine carcinomas as neuroendocrine carcinomas (NECs). Compared with welldifferentiated gastric NETs, GNECs have highly malignant behavior

* Correspondence: [e-mail] 1 Department of Surgery, Kansai Rousai Hospital, 3169 Inabaso, Amagasaki City, Hyogo 6608511, Japan Full list of author information is available at the end of the article

and poor prognosis, but their prognostic markers and therapeutic strategies have not yet been defined. A definite diagnosis of GNEC is provided by immu nohistochemical examination with neuroendocrine mar kers, such as synaptophysin (SYN), chromogranin A (CGA), CD56 and neuronspecific enolase (NSE). It has been proposed that care should be exercised in diagnosis because of the variation shown by GNECs in both histological morphology and immunohistochemical ex pression. However, no reports have investigated the rela tionship between the expression pattern at the primary site and that at the metastatic sites as to both histo logical morphology and immunohistochemical expres sion. In this study, we examined the primary tumors and all metastatic lymph nodes, and reviewed the association

© 2012 Uchiyama et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.