Expression of E-cadherin and CD44H in Borrmann Type IV Gastric Cancer

PURPOSE: E-cadherin and CD44H have been shown to play a role in the progression and the metastasis of tumors. This study evaluated the clinical correlations between expression of E-cadherin and CD44H and various clinicopathologic factors and the value of expressions of E-cadherin and CD44H as prognostic factors in Borrmann type IV gastric cancer. MATERIALS AND METHODS: In 122 patients with Borrmann type IV gastric cancer, we performed the immunohistochemical stainings for E-cadherin and CD44H. We analyzed the correlation between the expressions of E-cadherin and CD44H and lymphatic invasion, venous invasion, perineural invasion, histologic type, lymph node metastasis, depth of invasion, stage, and peritoneal dissemination, and survival. RESULTS: There were no correlations between reduced expression of E-cadherin and CD44H and lymphatic invasion, venous invasion, perineural invasion, histologic type, lymph node metastasis, depth of invasion, and stage. However, there was a significant correlation between lymph node metastasis and the lymphatic invasion (P=0.022). There was also a significant correlation between the peritoneal dissemination and CD44H expression (P=0.005). The 5-year survival rate was correlated with CD44H expression (P=0.026), peritoneal dissemination (P<0.01), depth of invasion (P<0.01), lymph node metastasis (P<0.01), stage of tumor (P<0.01), and lymphatic invasion (P<0.01). There was no correlation between expression of E-cadherin and survival rate. CONCLUSION: The expression of CD44H and peritoneal dissemination was correlated. The expression of CD44H was an independent prognostic factor in Borrmann type IV gastric cancer. Further prospective studies with a large number of cases are required.

Clinicopathologic Characteristics of Neuroendocrine Tumor of the Stomach

PURPOSE: Very few cases of neuroendocrine tumor of the stomach have been reported in Korea. The prognosis of gastric neuroendocrine tumors is known to be poorer than that of ordinary gastric carcinomas. The purpose of this retrospective study was to review the clinicopathologic features of seven cases of this unusual gastric tumor. METHODS: Excluding the tumor containing only sparse neuroendocrine differentiation, we resected 7 typical neuroendocrine tumors from January 1995 to December 1997 at Asan Medical Center; 2,346 gastric cancer patients were treated surgically during the same period. Average follow up period was 22.6 months. RESULTS: A typical well demarcated tumor margin was observed in four of the seven cases. The entire tumor was located on the distal stomach. Even when the tumor had deep ulcerations, the tumor cells had not infiltrated the serosal layer. Three cases showed recurrence of disease. All the recurrences were found in the liver within 12 months, and two of them, who were not indicated for chemotherapy, died within 10 months after diagnosis of recurrence. One patient with a recurrence was treated with systemic chemotherapy just after the diagnosis and was still alive after 29 months. CONCLUSION: Gastric neuroendocrine tumor frequently recurs the liver even in an early stage and especially when preoperative CEA is increased. We experienced a case of successful control of hepatic metastasis by using systemic chemotherapy.