Gastric Pit Dysplasia in Adjacent Gastric Mucosa in 414 Gastric Cancers

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Gastric Pit Dysplasia in Adjacent Gastric Mucosa in 414 Gastric Cancers

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Title: Gastric Pit Dysplasia in Adjacent Gastric Mucosa in 414 Gastric Cancers
Author: Shin, Nari; Jo, Hong-Jae; Kim, Woo-Kyung; Park, Won-Young; Lee, Jeong-Hee; Shin, Dong Hun; Choi, Kyung Un; Kim, Jee-Yeon; Lee, Chang-Hun; Sol, Mee Young; Jeon, Tae Yong; Kim, Dae Hyun; Huh, Gi-Young; Kim, Gwang Ha; Lauwers, Gregory Y.; Park, Do Youn

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Citation: Shin, Nari, Hong-Jae Jo, Woo-Kyung Kim, Won-Young Park, Jeong-Hee Lee, Dong Hun Shin, Kyung Un Choi, et al. 2011. “Gastric Pit Dysplasia in Adjacent Gastric Mucosa in 414 Gastric Cancers.” The American Journal of Surgical Pathology 35 (7) (July): 1021–1029. doi:10.1097/pas.0b013e31821ec495.
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Abstract: Despite wide acceptance of the chronic gastritis-intestinal metaplasia-dysplasia-carcinoma sequence, especially for intestinal-type gastric adenocarcinoma, the precise nature of the subtle precursor lesions of gastric cancer remains to be delineated. For example, pit dysplasia with surface foveolar maturation is not well defined, nor is its prevalence and biological characteristics well characterized. We have evaluated the surrounding gastric mucosa of 414 gastric cancers for the presence of gastric pit dysplasia. We investigated its relationship with various clinicopathological and immunophenotypic features of gastric adenocarcinoma, as well as the severity and extent of any surrounding gastritis and intestinal metaplasia. p53 expression and Ki-67 proliferation index were also evaluated. We have found that 21.0% (n=87) of gastric cancer cases showed pit dysplasia in adjacent gastric mucosa. Gastric cancers with pit dysplasia were significantly associated with older age, male sex, body/fundic location, and intestinal histologic type (P<0.05). Interestingly, gastric mucin-containing intestinal metaplasia (incomplete intestinal metaplasia) was highly associated with adenocarcinoma with pit dysplasia (P=0.000). In addition, MUC6 expression in gastric adenocarcinoma was associated with pit dysplasia (P=0.036). p53 overexpression and increased Ki-67 proliferation index were more evident in gastric pit dysplasia compared with adjacent gastric mucosa. We suggest that gastric pit dysplasia is an important candidate precursor of gastric adenocarcinoma and may represent another morphologic step in the pathogenesis of gastric adenocarcinoma, especially of intestinal type. More detailed prospective studies are needed to determine the precise significance of these findings.
Published Version: doi:10.1097/PAS.0b013e31821ec495
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