scholarly journals Computed tomographic pneumogastrography in determining the types of gastric cancer according to the Lauren classification

2021 ◽  
Vol 11 (2) ◽  
pp. 13-26
Author(s):  
A. D. Amelina ◽  
D. V. Nesterov ◽  
L. N. Shevkunov ◽  
A. M. Karachun ◽  
A. S. Artemyeva ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Mixed Type ◽  
Intestinal Type ◽  
Clinical Staging ◽  
Tumor Type ◽  
Diffuse Type ◽  
Computed Tomographic ◽  
Contrast Pattern ◽  
Definition Of ◽  
Stomach Tumor

Objective. To assess the capabilities of computed tomographic pneumogastrography in determining the types of gastric cancer according to the Lauren classification at the stage of clinical staging.Materials and methods. This study is a single-center retrospective study with 202 patients with gastric cancer included who was treated at the National Medical Research Center of Oncology named after N. N. Petrov from 2015 to 2018. All patients underwent subtotal gastric resection or gastrectomy and computed tomographic pneumogastrography at the stage of clinical staging. For patients undergoing neoadjuvant chemotherapy, CT was performed twice: before chemotherapy and after, immediately before surgery. We studied quantitative and qualitative imaging biomarkers, measured densitometric indices of stomach tumor density in the arterial, portal and delayed phases of scanning at five different points. For patients receiving NACT, all density indices were recorded twice — both before the start of therapeutic treatment, and after, immediately before the surgery.Results. The distribution of gastric cancer types according to Lauren»s classification was as follows: in 59 (29,2 %) intestinal type, 69 (34,2 %) — diffuse, 16 (7,9 %) — mixed, 58 (28,7 %) — indeterminate type. Based on visual characteristics, taking into account the characteristics of tumor growth, 3 main CT-PGG of the gastric cancer type were identified: 1 — tuberous (n = 68, 34,0 %), 2 — intramural (n = 57,3 %) and 3 — mixed (n = 77,4 %). CT-PGG tumor type is associated with Lauren type (χ2 = 185,19, p <0,001). With a tuberous CT-PGG type, it is possible to assume that the tumor is of an intestinal or indeterminate Lauren type; sensitivity 0,58 (95% CI: 0,49-0,67), specificity 0,1 (95% CI: 0,96-0,1). With an intramural CT-PGG type, the diffuse type of tumor according to Lauren is most likely; sensitivity 0,75 (95% CI: 0,64-0,85), specificity 0,96 (95% CI: 0,91-0,99). With a mixed CT-PGG type, the definition of the type according to Lauren is difficult. In the definition of mixed tumor type according to Lauren, the sensitivity and specificity of mixed CT-PGG tumor type are 0,94 (95% CI: 0,70% -0,1) and 0,67 (95% CI: 0,59-0,73) respectively.Conclusion. The shape of the stomach tumor, determined by CT-PGG, has a high diagnostic efficiency in determining the types of gastric cancer according to Lauren. The tuberous CT-PGG type is typical for tumors of the intestinal type according to Lauren, and the intramural CT-PGG type is typical for tumors of the diffuse type according to Lauren. Tumors of indeterminate Lauren type have any CT-PGG type and contrast pattern. For tumors of a mixed type according to Lauren, a mixed type according to CT-PGG is characteristic, but differential diagnosis with tumors of a tuberous and diffuse type according to Lauren of an atypical form for them is impossible. Tumors of the intestinal and diffuse Lauren type of the CT-PGG type, which is not typical for them, have an atypical contrast pattern.

scholarly journals Epithelial-mesenchymal transition in main types of gastric carcinoma

2021 ◽  
Vol 10 (2) ◽  
pp. 13-20
Author(s):  
I.V. Vasilenko ◽  
◽  
R.B. Kondratyk ◽  
I.S. Grekov ◽  
A.M. Yarkov ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Gastric Carcinoma ◽  
Mixed Type ◽  
Epithelial Mesenchymal Transition ◽  
Rapid Development ◽  
Tumor Formation ◽  
Intestinal Type ◽  
Diffuse Type ◽  
Vimentin Expression ◽  
Mesenchymal Transition

Introduction. The rapid development of basic science enabled us to significantly expand our understanding of various intercellular interactions. Epithelial-mesenchymal transition (EMT) is known to play a key role in certain tissue formation in the embryonic period. However, recent data show that EMT can also be observed in some pathological conditions, in particular, in various neoplasm development. This suggests that there are a number of alternative and fundamentally new mechanisms for the tumor formation and progression. Thus, EMT, which occurs in carcinomas, increases the invasiveness, immunoresistance, immunity to therapy, and the metastatic potential. Knowledge of EMT features and their timely recognition in morphological tumor diagnosis is of great predictive importance for patients. The aim of the research was to study the morphologi-cal features of epithelial-mesenchymal transition in the main types of gastric cancer. Materials and methods. We studied specimens of gastric carcinomas (N=64) including 31 cases of diffuse type, 19 cases of intestinal type, and 14 cases of mixed type. Results. All cases of the diffuse carcinoma group showed spread EMT features, which appeared already in the mucosa and completed with positive vimentin expression in 93.5% of cases. The malignant cell prolifera-tive activity was low; however, in 29% of cases we detected areas of moderate or even high activity. In the intestinal type gastric cancer, EMT developed as a result of tumor progression, it arose more often in the deeper layers and was incomplete and focal. As a rule, the proliferative activity of tumor cells was high and moderate. Vascular invasion occurred more often in diffuse type (90.3%), less often in mixed type (71.4%), and even less often in the intestine type (55.8%) gastric carcinoma. Conclusion. The variety of morphological features of EMT, its frequency, prevalence, completeness, and sequence in the development of various types of gastric cancer determines the features of their clinical manifestation and influences their further management. Keywords: gastric cancer, diagnosis, histological main types, EMT, morphopathology

scholarly journals The clinicopathological characteristics and genetic alterations of gastric cancer patients according to the Lauren classification

2020 ◽  
Author(s):  
Han-Fang Cheng ◽  
Kuo-Hung Huang ◽  
Ming-Huang Chen ◽  
Wen-Liang Fang ◽  
Chien-Hsing Lin ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Mixed Type ◽  
Disease Free Survival ◽  
Genetic Alterations ◽  
Clinicopathological Features ◽  
Intestinal Type ◽  
Diffuse Type ◽  
Lauren Classification ◽  
Borrmann Type ◽  
Laurén Classification

ObjectiveThe Lauren classification is an important histological classification of gastric cancer (GC) with different biological behaviors between histological types.BackgroundTo date, there are few reports on the genetic alterations and survival differences between different histological types according to the Lauren classification.MethodsIn total, 433 GC patients undergoing surgery were enrolled. The clinicopathological features, prognoses, and genetic alterations of the different Lauren types were compared.ResultsDiffuse-type GC was associated with a younger age, female predominance, more Borrmann type 3 and 4 tumors, more advanced pathological tumor (T) and node (N) categories, more tumor recurrences (especially peritoneal recurrence), and worse 5-year overall survival and disease-free survival rates than intestinal-type GC and mixed-type GC. Regarding genetic alterations, mixed-type GC was associated with more TP53 mutations than intestinal-type GC and diffuse-type GC. Multivariate analysis demonstrated the following independent prognostic factors: age, Lauren classification, and pathological T and N categories. Regarding mixed-type GC, diffuse-type major tumors were associated with more lymphovascular invasion, a more advanced N category and TNM stage, and fewer PI3K/AKT pathway mutations than intestinal-type major tumors.ConclusionsDiffuse-type GC had unfavorable clinicopathological features and a worse prognosis than intestinal-type GC. For mixed-type GC, the clinicopathological features and genetic alterations were different between intestinal-type major tumors and diffuse-type major tumors.

The relationship between HER-2 and TOPO-2A gene expression and clinicopathologic results in gastric cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14670-e14670
Author(s):  
Metin Ozkan ◽  
Esra Ermis Turak ◽  
Halit Karaca ◽  
Mevlude Inanc ◽  
Veli Berk ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Median Overall Survival ◽  
Intestinal Type ◽  
Negative Group ◽  
Diffuse Type ◽  
Her 2 ◽  
Gastric Cancer Patients

e14670 Background: HER-2 and Topo-2A genes are settled on a chromosome 17 and their co-amplification rates are high. In this study, early gastric cancer patients who received adjuvant chemo-radiotherapy and chemotherapy were evaluated with HER-2 and Topo-2A expression in association with clinical and histopathologic findings. Methods: A total of 103 gastric cancer patients were included the study. The HER-2 and Topo-2A levels were measured by immunohistochemistry in postoperative tumor materials. A standard evaluation method was admitted for HER-2 positivity, while Topo-2A nuclear staining 3+ and 4+ were considered as overexpression. Those with level 2+ or 3+ of HER-2, the FISH test were attempted. Results: The median follow-up was 19 months (ranges 2–70 months). Forty-six patients (44%) relapsed during follow-up whereas 60 patients (58%) had died. The median overall survival (mOS) was 23 months. Histopathologies of HER-2 positive patients were intestinal type in 7 (87.5%) and diffuse type in one (12.5%) patient. In the follow-up period 4 patients (50%) were died (mOS was 17 months in this group). Median overall survival was 23 months in HER-2 negative group (p=0.6). Histopathologies of Topo-2A positive patients were intestinal type in 9 (64.2%) and diffuse type in 5 (35.8%) patient. In the follow-up period 8 patients (57%) were died (mOS was 22 months in this group). Median overall survival was 23 months in Topo-2A negative group (p=0.8). Three patients (37.5%) who had HER-2 positive histopathologies also had Topo-2A positivity. Conclusions: Overexpression rates of HER-2 in gastric cancer were reported 6.8-34%. Racial differences and different scoring techniques thought to be impact the results. Co-amplification rate of HER-2 and Topo-2A was reported 34% in gastric cancer. In our study HER-2 and Topo-2A overexpression rates were 7.7% and 13.6% respectively and co-amplification of HER-2 with Topo-2A rate was 37.5% is also similar to the other studies. Stages of patients with HER-2 and Topo-2A overexpression were similar to the distribution of the overall patients. While intestinal subtypes showed a higher rate of HER-2 overexpression, the median survival times tend to be shorter in HER-2 positive patients.

scholarly journals Different clinical significance of FGFR1–4 expression between diffuse-type and intestinal-type gastric cancer

2017 ◽  
Vol 15 (1) ◽  
Author(s):  
Mikito Inokuchi ◽  
Hideaki Murase ◽  
Sho Otsuki ◽  
Tatsuyuki Kawano ◽  
Kazuyuki Kojima
Keyword(s):  
Gastric Cancer ◽  
Clinical Significance ◽  
Intestinal Type ◽  
Diffuse Type

scholarly journals Association Between DCE-MRI Perfusion Histogram Parameters and EGFR and VEGF Expressions in Different Lauren Classifications of Advanced Gastric Cancer

2022 ◽  
Vol 27 ◽  
Author(s):  
Zhiheng Li ◽  
Zhenhua Zhao ◽  
Chuchu Wang ◽  
Dandan Wang ◽  
Haijia Mao ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Growth Factor ◽  
Advanced Gastric Cancer ◽  
Predictive Value ◽  
Intestinal Type ◽  
Imaging Biomarkers ◽  
Diffuse Type ◽  
Vegf Expression ◽  
Dce Mri ◽  
Sensitivity Specificity

Objective: To investigate the correlations between dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) perfusion histogram parameters and vascular endothelial growth factor (VEGF) and epidermal growth factor receptor (EGFR) expressions in advanced gastric cancer (AGC).Methods: This retrospective study included 80 pathologically confirmed patients with AGC who underwent DCE-MRI before surgery from February 2017 to May 2021. The DCE-MRI perfusion histogram parameters were calculated by Omni Kinetics software in four quantitative parameter maps. Immunohistochemical methods were used to detect VEGF and EGFR expressions and calculate the immunohistochemical score.Results: VEGF expression was relatively lower in patients with intestinal-type AGC than those with diffuse-type AGC (p &lt; 0.05). For VEGF, Receiver operating characteristics (ROC) curve analysis revealed that Quantile 90 of Ktrans, Meanvalue of Kep and Quantile 50 of Ve provided the perfect combination of sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for distinguishing high and low VEGF expression, For EGFR, Skewness of Ktrans, Energy of Kep and Entropy of Vp provided the perfect combination of sensitivity, specificity, PPV and NPV for distinguishing high and low EGFR expression. Ktrans (Quantile 90, Entropy) showed the strongest correlation with VEGF and EGFR in patients with intestinal-type AGC (r = 0.854 and r = 0.627, respectively); Ktrans (Mean value, Entropy) had the strongest correlation with VEGF and EGFR in patients with diffuse-type AGC (r = 0.635 and 0.656, respectively).Conclusion: DCE-MRI perfusion histogram parameters can serve as imaging biomarkers to reflect VEGF and EGFR expressions and estimate their difference in different Lauren classifications of AGC.

scholarly journals Cardia Gastric Cancer Is Associated With Increased PIK3CA Amplifications and HER2 Expression Than Noncardia Gastric Cancer According to Lauren Classification

2021 ◽  
Vol 11 ◽  
Author(s):  
Shih-Min Pai ◽  
Kuo-Hung Huang ◽  
Ming-Huang Chen ◽  
Wen-Liang Fang ◽  
Yee Chao ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Prognostic Factor ◽  
Multivariable Analysis ◽  
Disease Free Survival ◽  
Genetic Alterations ◽  
Clinicopathological Features ◽  
Independent Prognostic Factor ◽  
Intestinal Type ◽  
Diffuse Type ◽  
Recurrence Patterns

BackgroundTo date, few reports have investigated genetic alterations and clinicopathological features in cardia and noncardia gastric cancer (GC).MethodsIn total, 435 GC patients receiving curative surgery were included. The clinicopathological features, recurrence patterns, prognoses and genetic alterations were compared between cardia and noncardia GC patients.ResultsAmong the 435 enrolled patients, 47 (10.8%) had cardia GC. Compared with noncardia GC, cardia GC was associated with more intestinal-type tumors and similar initial recurrence patterns and 5-year overall survival (OS; 50.8% vs. 50.5%, P = 0.480) and disease-free survival (DFS; 48.6% vs. 48.9%, P = 0.392) rates. For both intestinal-type GC and diffuse-type GC, the clinicopathological features and 5-year OS and DFS rates were not significantly different between the cardia and noncardia GC patients. Multivariable analysis showed that cardia GC was not an independent prognostic factor. Compared with noncardia GC, cardia GC was associated with increased PIK3CA amplification than in patients with intestinal-type GC and was associated with increased HER2 expression in patients with diffuse-type GC.ConclusionsCardia GC is not an independent prognostic factor. In cardia GC patients with intestinal-type GC, PIK3CA amplification was more common, and in those with diffuse-type GC, HER2 expression was more common. Targeted therapy may be beneficial for these patient subgroups.

Evaluation of prognostic factors in gene expression and clinicopathologic characteristics in patients with adjuvant chemotherapy for advanced gastric cancer.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 61-61
Author(s):  
M. Azuma ◽  
K. Ishido ◽  
A. Takeuchi ◽  
A. Naruke ◽  
K. Higuchi ◽  
...  
Keyword(s):  
Gene Expression ◽  
Gastric Cancer ◽  
Adjuvant Chemotherapy ◽  
Prognostic Factor ◽  
Intestinal Type ◽  
Diffuse Type ◽  
Gene Expressions ◽  
Group Iii ◽  
Type Group ◽  
Group I

61 Background: We reported TS expression is an independent prognostic factor in patients with gastric cancer who received postoperative adjuvant chemotherapy with S-1 at 2010 ASCO GI (abstract 32). These pharmacogenomic finding will help for choosing chemotherapeutic agents for personalized therapy in the future. Our aim was to indicate association of TS expression with clinicopathological characteristics in the same patient population. Methods: 39 patients with stage II or III advanced gastric cancer who underwent gastrectomy were analyzed. These patients received adjuvant chemotherapy with S-1 after surgery. Formalin-fixed, paraffin-embedded tumor tissues were dissected by the laser-captured microdissection technique and analyzed for target gene expressions using a quantitative real-time PCR. Results: There were no significant differences between stage II and III in TS gene expressions. TS expression (low ≤ 0.72, high > 0.72) and histological type (intestinal and diffuse) are evaluated for PFS and OS. Patients were classified as Group I (n = 5); low TS and intestinal type, Group II (n = 14); low TS and diffuse type, Group III (n = 13); high TS and diffuse type and Group IV (n = 7); high TS and intestinal type. There were significant differences between these four groups (Kaplan-Meier survival analysis, log-rank test, PFS: p = 0.0112 OS: p = 0.0128). The survival curve showed longer survival both PFS and OS in Groups 1 > 2 > 3 > 4. In low TS situation (responders as Group I and II), there is a trend in patients with intestinal type had a longer survival compared to diffuse type (Group I > II). In high TS situation (non-responders as Group III and IV), the result are opposite, there is a trend in patients with diffuse type had a longer survival compared to Intestinal type (Group III > IV). Conclusions: These data suggest that TS gene expression levels may be molecular markers of prognostic factor for patients with adjuvant chemotherapy for resectable gastric cancer. S-1 might be effect different behavior by both histological type and TS expression. Prospective studies are needed to validate these preliminary findings. No significant financial relationships to disclose.

scholarly journals Asporin Expression on Stromal Cells and/or Cancer Cells Might Be A Useful Prognostic Marker in Patients with Diffuse-Type Gastric Cancer

2021 ◽  
pp. 1-8
Author(s):  
Masakazu Yashiro ◽  
Tsuyoshi Hasegawa ◽  
Yurie Yamamoto ◽  
Gen Tsujio ◽  
Sadaaki Nishimura ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Cancer Cells ◽  
Prognostic Marker ◽  
Cancer Progression ◽  
Stromal Cells ◽  
Intestinal Type ◽  
Human Gastric Cancer ◽  
Diffuse Type ◽  
Diffuse Type Gastric Cancer

<b><i>Background:</i></b> Asporin (ASPN), a member of the proteoglycan family, has been shown to have a close correlation with cancer progression. It is not known whether ASPN is an oncogenic driver or a tumor suppressor in human gastric cancer. We sought herein to determine the relationship between ASPN expression and clinicopathological features of gastric cancer. <b><i>Patients and Methods:</i></b> A total of 296 gastric cancer patients (diffuse type, <i>n</i> = 144; intestinal type, <i>n</i> = 152) were enrolled. The ASPN expression level in each case was analyzed by immunohistochemistry. <b><i>Results:</i></b> ASPN was mainly found on stromal cells, especially on fibroblasts in tumor stroma, i.e., cancer-associated fibroblasts. The ASPN expression on either cancer cells or stromal cells was significantly high in macroscopic scirrhous-type tumors (<i>p</i> &#x3c; 0.001) and histologically abundant stroma-type tumors (<i>p</i> &#x3c; 0.001). Interestingly, a Kaplan-Meier survival curve of the 144 cases of diffuse-type gastric cancer revealed a significantly poorer prognosis in patients with ASPN-positive expression (<i>p</i> = 0.043; log rank) compared to those with ASPN-negative expression, but the prognoses were not significantly different in these subgroups of the 152 cases of intestinal-type gastric cancer. A multivariate analysis with respect to overall survival showed that ASPN expression on stromal cells and/or cancer cells was significantly correlated with overall survival in patients with diffuse-type gastric cancer (<i>p</i> = 0.041). <b><i>Conclusion:</i></b> In gastric cancer, ASPN was expressed mainly on stromal cells and partially on cancer cells. ASPN expression on stromal cells and/or cancer cells might be a useful prognostic marker in patients with diffuse-type gastric cancer.

scholarly journals Intratumoral and peritumoral radiomics analysis for preoperative Lauren classification in gastric cancer

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Xiao-Xiao Wang ◽  
Yi Ding ◽  
Si-Wen Wang ◽  
Di Dong ◽  
Hai-Lin Li ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Clinical Characteristics ◽  
Characteristic Curve ◽  
Clinical Usefulness ◽  
Intestinal Type ◽  
Diffuse Type ◽  
Lauren Classification ◽  
Preoperative Prediction ◽  
Peripheral Ring ◽  
Laurén Classification

Abstract Background Preoperative prediction of the Lauren classification in gastric cancer (GC) is very important to the choice of therapy, the evaluation of prognosis, and the improvement of quality of life. However, there is not yet radiomics analysis concerning the prediction of Lauren classification straightly. In this study, a radiomic nomogram was developed to preoperatively differentiate Lauren diffuse type from intestinal type in GC. Methods A total of 539 GC patients were enrolled in this study and later randomly allocated to two cohorts at a 7:3 ratio for training and validation. Two sets of radiomic features were derived from tumor regions and peritumor regions on venous phase computed tomography (CT) images, respectively. With the least absolute shrinkage and selection operator logistic regression, a combined radiomic signature was constructed. Also, a tumor-based model and a peripheral ring-based model were built for comparison. Afterwards, a radiomic nomogram integrating the combined radiomic signature and clinical characteristics was developed. All the models were evaluated regarding classification ability and clinical usefulness. Results The combined radiomic signature achieved an area under receiver operating characteristic curve (AUC) of 0.715 (95% confidence interval [CI], 0.663–0.767) in the training cohort and 0.714 (95% CI, 0.636–0.792) in the validation cohort. The radiomic nomogram incorporating the combined radiomic signature, age, CT T stage, and CT N stage outperformed the other models with a training AUC of 0.745 (95% CI, 0.696–0.795) and a validation AUC of 0.758 (95% CI, 0.685–0.831). The significantly improved sensitivity of radiomic nomogram (0.765 and 0.793) indicated better identification of diffuse type GC patients. Further, calibration curves and decision curves demonstrated its great model fitness and clinical usefulness. Conclusions The radiomic nomogram involving the combined radiomic signature and clinical characteristics holds potential in differentiating Lauren diffuse type from intestinal type for reasonable clinical treatment strategy.

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