PT  - JOURNAL ARTICLE
AU  - Cassaro, Mauro
AU  - Rugge, Massimo
AU  - Tieppo, Chiara
AU  - Giacomelli, Luciano
AU  - Velo, Daniela
AU  - Nitti, Donato
AU  - Farinati, Fabio
TI  - Indefinite for non-invasive neoplasia lesions in gastric intestinal metaplasia: the immunophenotype
AID  - 10.1136/jcp.2006.040386
DP  - 2007 Jun 01
TA  - Journal of Clinical Pathology
PG  - 615--621
VI  - 60
IP  - 6
4099  - http://jcp.bmj.com/content/60/6/615.short
4100  - http://jcp.bmj.com/content/60/6/615.full
SO  - J Clin Pathol2007 Jun 01; 60
AB  - Background: In the Padova International Classification, gastric precancerous lesions are labelled as “indefinite for non-invasive neoplasia” (Indef-NiN) cytohistological alterations mimicking non-invasive neoplasia (NiN), but lacking all the attributes required for a definite NiN categorisation. Aim: To apply a panel of immunohistochemical (IHC) markers of cell proliferation (Mib1), intestinal differentiation (Cdx2), apoptosis (pro-caspase 3) and cell immortalisation (hTERT) to compare the IHC profiles of a series of precancerous lesions arising in gastric intestinalised (ie, IM-positive) glands. Materials and methods: By applying the histological criteria consistently provided by both the Padova Classification and the World Health Organization International Agency, 112 consecutive cases were considered: intestinal metaplasia (IM; n = 54), Indef-NiN in IM-positive gastric glands (n = 28) and low-grade (LG) NiN (n = 30). In each histological category, the expression of the marker was separately scored in superficial, proliferative and coil compartments. Results: In all glandular compartments, Mib1, Cdx2, hTERT and pro-caspase 3 were consistently more expressed in LG-NiN than in either IM or Indef-NiN lesions (analysis of variance: p<0.001). Significant ORs (calculated by ordinal logistic regression analysis for each glandular compartment) associated IM, Indef-NiN and LG-NiN with the expression of the considered markers. Conclusions: A consistent overexpression (unrestricted to the proliferative zone) of IHC markers of cell proliferation, intestinal differentiation, decreased apoptosis and cell immortalisation differentiates LG-NiN from both (simple) IM and Indef-NiN (arising in IM). An increased proliferative activity in the proliferative zone discriminates Indef-NiN lesions (ie, hyperproliferative IM) from IM. Such divergent IHC profiles may provide a rationale for scheduling follow-up protocols more properly tailored on the patient’s risk for cancer.