Sasaki I, Yao T, Nawata H, Tsuneyoshi M
Second Department of Pathology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Cancer. 1999 Apr 15;85(8):1719-29.
The differentiated type of minute gastric carcinoma (MGC), measuring less than 5 mm in greatest dimension, has been considered to represent the incipient phase of gastric carcinoma. To determine the clinicopathologic features of MGCs, the authors examined tissues from MGCs with a view to clarifying their histopathologic diversity. The immunohistochemistry of these tissues was determined using monoclonal antibody against p53 and Ki-67, and their mucin-histochemical types were determined with reference to the presence of intestinal metaplasia (IM) within their surrounding mucosa.
One hundred three specimens were obtained from 93 patients with MGCs. Each lesion was evaluated both macroscopically and histologically, and the degree of IM was assessed. All sections were examined mucin-histochemically with Con A, GOS, and HID-AB, and stained with commercially available monoclonal antibodies, PAb 1801 and Ki-67. Additional nonminute carcinomas present within the same stomachs were used as controls.
Macroscopically, most lesions were depressed. IM was noted in the surrounding mucosa of 85 MGCs (82.5%). Immunohistochemically, 25 MGCs (24.2%) showed p53 overexpression, although the rate of p53 overexpression was increased to 34.6% in other nonminute carcinomas from the same stomachs. Twenty-four MGCs were associated with a proliferative zone, demonstrated by Ki-67 positive cells. Statistically significant differences in the rate of p53 overexpression were observed between MGCs with a proliferative zone and those without. Mucin phenotypes of MGCs tended to imitate their own surrounding mucosa.
The MGCs, which represent the incipient phase of early gastric carcinoma, have various histologic, immunohistochemical, and mucin-histochemical features. It would seem that p53 expression is more closely related to the progression of MGCs than to their carcinogenesis.
最大直径小于5mm的微小胃癌（MGC）的分化型被认为代表胃癌的早期阶段。为了确定MGC的临床病理特征，作者检查了MGC组织，以阐明其组织病理学多样性。使用抗p53和Ki-67单克隆抗体对这些组织进行免疫组织化学检测，并根据其周围黏膜中肠化生（IM）的存在情况确定其黏液组织化学类型。
从93例MGC患者中获取103个标本。对每个病变进行宏观和组织学评估，并评估IM程度。所有切片均用Con A、GOS和HID-AB进行黏液组织化学检查，并用市售单克隆抗体PAb 1801和Ki-67染色。同一胃内存在的其他非微小癌用作对照。
宏观上，大多数病变为凹陷型。85个MGC（82.5%）的周围黏膜有IM。免疫组织化学检测显示，25个MGC（24.2%）有p53过表达，尽管来自同一胃的其他非微小癌中p53过表达率增至34.6%。24个MGC与增殖区相关，Ki-67阳性细胞证实了这一点。有增殖区和无增殖区的MGC之间，p53过表达率存在统计学显著差异。MGC的黏液表型倾向于与其周围黏膜相似。
代表早期胃癌早期阶段的MGC具有多种组织学、免疫组织化学和黏液组织化学特征。似乎p53表达与MGC的进展比与其致癌作用更密切相关。
