J Korean Med Sci.  2009 Dec;24(6):1158-1164. 10.3346/jkms.2009.24.6.1158.

Clinicopathological Characteristics and Predictive Markers of Early Gastric Cancer with Recurrence

• Kim JW
• Hwang I
• Kim MJ
• Jang SJ

• KMID: 1783148
• DOI: http://doi.org/10.3346/jkms.2009.24.6.1158

Abstract

Early gastric cancer (EGC) is a "curable" disease with a high cure rate made possible through proper surgical treatment; nonetheless, some patients sustain a disease recurrence after curative resection. The aim of this study was to identify the clinicopathological characteristics of recurrent EGC and determine predictable immunohistochemical markers for recurrence. We investigated the clinicopathological features of 1,786 EGC cases, and using tissue microarray, the expression of c-erbB-2, EGFR, MLH1, MSH2, p53, and AQP1 was examined in group with recurrence and control group without recerrence. In the clinical analysis, 32 of 1,786 (1.79%) patients showed recurrence, with a 2.04% five-year cumulative recurrence rate. Age, submucosal invasion, and lymph node metastasis significantly correlated with tumor recurrence (P=0.044, 0.019, and <0.001, respectively). Multivariate analysis showed lymph node status and old age (> or =57 yr) as independent risk factors of recurrence. In a case-control study, immunopositivity for c-erbB-2 was significantly associated with disease recurrence (P=0.024). There is the probability that EGC patients with old age (> or =57 yr), lymph node metastasis, submucosal invasion, and c-erbB-2 immunopositivity will experience recurrence; therefore, it is critical that patients with these risk factors be followed-up closely and considered candidates for adjuvant treatment.

Keyword

Early Gastric Cancer; Recurrence; Lymph Node Metastasis; Immunohistochemistry; Genes, erbB-2

MeSH Terms

Adult
Aged
Animals
Female
Genes, erbB-2
Humans
Immunohistochemistry/methods
Male
Microarray Analysis/methods
Middle Aged
Multivariate Analysis
*Neoplasm Recurrence, Local/metabolism/pathology
Prognosis
Risk Factors
*Stomach Neoplasms/metabolism/pathology
Tumor Markers, Biological/*metabolism

Figure

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  Fig. 1 c-erbB2 immunohistochemical analysis. (A) 1+, faint (×100); (B) 2+, weak to moderate complete membranous (×200); (C) 3+, strong and complete membranous (×400); and (D) 3+, strong basalateral membranous reactivities (×400).

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