Gastric Mucin Phenotype Indicated Aggressive Biological Behavior in Early Differentiated Gastric Adenocarcinomas by Endoscopic Treatment

Abstract Background:The distribution of mucin phenotypes and its relationship with clinicopathological features in early differentiated gastric adenocarcinomas among the Chinese cohort is unknow. We aim to investigate the mucin phenotypes and analyze the relationship between mucin phenotypes and clinicopathological features, especially the biological behavior, in early differentiated gastric adenocarcinomas from endoscopic specimens in a Chinese cohort. Methods: Immunohistochemical staining of CD10, MUC2, MUC5AC, MUC6 was performed in 257 patients with early differentiated gastric adenocarcinomas. Tumor location, gross type, tumor size, histological type, depth of invasion, lymphovascular invasion, mucosal background and other clinicopathological parameters were evaluated. Analyzed the relationship between mucin phenotypes and clinicopathological features through chi-square test.ResultsThe incidence of ໿ gastric-, gastrointestinal-, intestinal- and null-phenotype was 21%, 56%, 20% and 3% respectively. The mucin phenotypes were related with histology classification (P༜0.05). The proportion of gastric-phenotype became greater during the transition from differentiated to undifferentiated (P༜0.05). Complete intestinal metaplasia in gastric- and intestinal-phenotype was higher than gastrointestinal-phenotype (P༜0.05). Those mixed with poorly differentiated adenocarcinoma were mainly of gastric-phenotype, which was significantly higher than that of purely differentiated tubular adenocarcinoma (P < 0.05), and the depth of infiltration of mixed type was deeper (P < 0.05). Neither recurrence nor metastasis were detected.ConclusionsThe mucin phenotype of early differentiated gastric adenocarcinoma is of clinical implication, and gastric-phenotype has aggressive biological behavior in early differentiated gastric cancers, especially in those mixed with poorly differentiated adenocarcinoma or papillary adenocarcinoma component.