Gastroenterology

Gastroenterology

Volume 114, Issue 3, March 1998, Pages 462-470
Gastroenterology

Alimentary Tract
Dimeric sialyl-Lex expression in gastric carcinoma correlates with venous invasion and poor outcome,☆☆

https://doi.org/10.1016/S0016-5085(98)70529-3Get rights and content

Abstract

Background & Aims: High expression of sialyl-Lex in tumors of different organs correlates with hematogenous metastasis and adverse outcome. Dimeric sialyl-Lex expression in gastric carcinoma was evaluated, and its prognostic significance within this setting was determined. Methods: Dimeric sialyl-Lex immunohistochemical expression in 97 gastric carcinomas was analyzed using the FH6 monoclonal antibody. Scoring was based on the percentage of immunoreactive cells: negative, low expression (≤25%), and high expression (>25%). Results: Immunoreactivity was observed in 45 cases (46.4%), encompassing 27 and 18 cases with low and high expression, respectively. Significant relationships were found between dimeric sialyl-Lex expression and venous invasion (P = 0.0025) and histological classification (P = 0.05). No correlation was observed with other clinicopathologic features. Patients with tumors showing high expression of dimeric sialyl-Lex had a significantly shorter survival time than those with low or no expression (P = 0.03). By multivariate analysis, pathological TNM (pTNM) staging and venous invasion emerged as independent prognostic factors in the whole series. Within the group of patients with tumors in pTNM stages II and III, dimeric sialyl-Lex was the only independent prognostic factor. Conclusions: High expression of dimeric sialyl-Lex correlates with venous invasion and poor outcome in gastric carcinoma.

GASTROENTEROLOGY 1998;114:462-470

Section snippets

Materials and methods

Surgical specimens from 97 gastric carcinomas resected consecutively at Hospital S. João-Medical Faculty of Porto were included in the study. All tissue samples were collected after informed consent. Tissue fragments were fixed in 10% formaldehyde and embedded in paraffin. Sections of 4 μm were cut from each representative paraffin block and stained with H&E to evaluate and classify the lesions. Serial sections of each case were used for orcein staining (detection of vascular invasion) and

Relationship between dimeric S-Lex expression and clinicopathologic features

Immunoreactivity was either absent or restricted to mucous neck cells in normal-appearing gastric mucosa distant from tumors. In the gastric mucosa at the immediate periphery of tumors, weak expression of dimeric S-Lex antigen was observed in 78% of the cases, usually in the cytoplasm of neck and foveolar/superficial cells. Dimeric S-Lex was expressed in 45 of 97 gastric carcinoma cases (46.4%). Immunoreactivity was observed at the cell membrane (Figure 1) or in the cytoplasm (Figure 2) and

Discussion

In the present study, we analyzed the immunohistochemical expression of dimeric S-Lex in gastric carcinomas and its relationship with the clinicopathologic features of the tumors and the survival rate of the patients.

In nonneoplastic mucosa, the expression of dimeric S-Lex, when present, was only observed in the neck cells. This finding is in agreement with the previously reported restricted immunoreactivity of FH6 antibody in normal adult tissues.25 In gastric carcinomas, we detected dimeric

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  • Cited by (0)

    Address requests for reprints to: Margarida Amado, Ph.D., Institute of Molecular Pathology and Immunology of University of Porto, IPATIMUP, Rua Dr. Roberto Frias s/n, 4200 Porto, Portugal. Fax: (351) 2-557-0799.

    ☆☆

    Supported by project 2/2.1/SAU/1356/95 from PRAXIS XXI.

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