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KMID : 0352519950320030356
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Korea Univercity Medical Journal
1995 Volume.32 No. 3 p.356 ~ p.374
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The Expression Rate of c-erbB-2, p53 protein and PCNA in Gastric Dysplasia and Intestinal Metaplasia Adjacent to Gastric Cancer and its Significance
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Lee Jae-Bok
Kim Han-Kyeom
Hyun Jin-Hae
Kim Re-Hwe
Whang Jeong-Woong
Kim Sae-Min
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Abstract
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It has been postulated that dysplasia and intestinal metaplasia are precancerous stages of gastric tumorigenesis. It is known that c-erbB-2 and p53 oncoprotein are expressed in some gastric cancer and adjacent epithelia. To define the significance of dysplasia and intestinal metaplasia as a precancerous lesion, the expression rate of c-erbB-2 and p53 oncoprotein were immunohistochemically evaluated and compared with clinicopathologicalcharacteristics and PCNA index in the gastric cancer and adjacent dysplastic, metaplastic and normal mucosa. From the resected stomach of 56 gastric cancer patients who had been operated on July 25 through September 23 of 1992. 56 cases of cancerous tissue, dysplasia 21 cases, intestinal metaplasia 43 cases and normal mucosa 21 cases were selected and evaluated, respectively.
The results were summarized as follows:
1. The expression rates of c-erbB-2 protein were 13/56(23.2%) in gastric cancer, 4/21(19.0%) in dysplasia, 2/43(4.6%) in intestinal metaplasia and 0/21 in normal mucosa. (p=0.007)
2. The expression rates of p53 protein were 26/56 (46.4%) in gastric cancer, 4/21 (19.1%) in dysplasia, 0/43 in intestinal metaplasia and 0/21 in normal mucosa. (p=0.000)
3. PCNA labeling indices were 43.9±18.1% in gastric cancer, 35.1±8.2% in dysplasia, 28.0±16.1% in intestinal metaplasia and 12.8±9.6% in normal mucosa. (p=0.000)
4. In the neck and basal portion of gastric glandular structures, PCNA labeling indices of dysplasia and metaplasia were higher than the index of normal mucosa. (p<0.05)
5. The cancerous tissue showed higher c-erbB-2 protein expression rate in the differentiated, intestinal- type of cancer than undifferentiated, diffuse type and the dysplasic rnucosa adjacent to advanced gastric cancer showed higher c-erbB-2 protein expression rate than early gastric cancer.
6. There was no significant correlation between p53 protein expression and clinicopathological variables.
7. Positive expression of c-erbB-2 protein showed high PCNA labeling index in the advanced, diffuse-type and undifferentiated gastric cancer, with lymphovascular emboli but the p53 expression was not closely related to the poor prognostic factors of gastric cancer.
The above result showed that c-erbB-2 protein was expressed in the dysplastic and metaplastic gastric mucosa adjacent to the gastric cancer and that p53 protein was expressed in the dysplastic gastric mucosa. In the advenced gastric cancer, positive expression of c-erbB-2 and p53 protein in the dysplastic mucosa showed high proliferating activity. Despite limited cases of dysplastic lesion adjacent to gastric cancer, the dysplastic mucosa should be evaluated to precancerous lesion and the immunohistochemical staining of c-erbB-2 and p53 protein might prove useful in monitoring the evaluation of the disease in the follow-up patients at risk of developing gastric cancer.
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KEYWORD
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