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Adenomatous and foveolar gastric dysplasia: distinct patterns of mucin expression and background intestinal metaplasia.
Am J Surg Pathol. 2008 Apr; 32(4):524-33.AJ

Abstract

Gastric epithelial dysplasia (GED) can be morphologically categorized into adenomatous (or intestinal) and foveolar (or gastric) types. Although limited genetic differences have been demonstrated between these subtypes, the expression of various mucins has not been systematically evaluated in this context. Endoscopic mucosal resections from 69 cases of GEDs were evaluated for the expression of MUC2, MUC5AC, MUC6, and CD10. The results were correlated with morphologic categorization and clinicopathologic parameters. GED was classified as adenomatous, foveolar, or hybrid (showing features of both types), on the basis of histologic evaluation. The neighboring intestinal metaplasia (IM) was also evaluated. An adenomatous morphology was seen in 45%, hybrid type in 33.3%, and a "pure" foveolar type was seen in 21.7% of the cases. Foveolar GED was often depressed/flat on endoscopy and showed a statistically significant association with high-grade morphology (P = 0.046). Immunohistochemistry confirmed the histologic stratification. The foveolar and hybrid types were more often positive for MUC5AC (P = 0.0001 for both) and negative for CD10 (P = 0.019 and 0.016, respectively) as compared with adenomatous GED. High-grade morphology was associated with MUC5AC expression regardless of the morphologic phenotype (P = 0.026). Foveolar (73.3%) and hybrid (86.9%) GEDs were associated more often with IM showing a retained expression of gastric type mucin than adenomatous GED (29%) (P < 0.01 for both). In contrast, adenomatous type (58.1%) of GED was significantly associated with IM showing a complete intestinal phenotype (CD10+) compared with the foveolar (13.3%) and hybrid types (17.4%) of GED (P = 0.005 for both comparisons). In conclusion, our study indicates that foveolar and adenomatous types of GED have distinct clinicopathologic features, mucin profiles, and association with different types of IM.

Authors+Show Affiliations

Department of Pathology, Massachusetts General Hospital, Boston, MA 02114-2696, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18300795

Citation

Park, Do Youn, et al. "Adenomatous and Foveolar Gastric Dysplasia: Distinct Patterns of Mucin Expression and Background Intestinal Metaplasia." The American Journal of Surgical Pathology, vol. 32, no. 4, 2008, pp. 524-33.
Park DY, Srivastava A, Kim GH, et al. Adenomatous and foveolar gastric dysplasia: distinct patterns of mucin expression and background intestinal metaplasia. Am J Surg Pathol. 2008;32(4):524-33.
Park, D. Y., Srivastava, A., Kim, G. H., Mino-Kenudson, M., Deshpande, V., Zukerberg, L. R., Song, G. A., & Lauwers, G. Y. (2008). Adenomatous and foveolar gastric dysplasia: distinct patterns of mucin expression and background intestinal metaplasia. The American Journal of Surgical Pathology, 32(4), 524-33. https://doi.org/10.1097/PAS.0b013e31815b890e
Park DY, et al. Adenomatous and Foveolar Gastric Dysplasia: Distinct Patterns of Mucin Expression and Background Intestinal Metaplasia. Am J Surg Pathol. 2008;32(4):524-33. PubMed PMID: 18300795.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Adenomatous and foveolar gastric dysplasia: distinct patterns of mucin expression and background intestinal metaplasia. AU - Park,Do Youn, AU - Srivastava,Amitabh, AU - Kim,Gwang Ha, AU - Mino-Kenudson,Mari, AU - Deshpande,Vikram, AU - Zukerberg,Lawrence R, AU - Song,Geum Am, AU - Lauwers,Gregory Y, PY - 2008/2/28/pubmed PY - 2008/5/30/medline PY - 2008/2/28/entrez SP - 524 EP - 33 JF - The American journal of surgical pathology JO - Am. J. Surg. Pathol. VL - 32 IS - 4 N2 - Gastric epithelial dysplasia (GED) can be morphologically categorized into adenomatous (or intestinal) and foveolar (or gastric) types. Although limited genetic differences have been demonstrated between these subtypes, the expression of various mucins has not been systematically evaluated in this context. Endoscopic mucosal resections from 69 cases of GEDs were evaluated for the expression of MUC2, MUC5AC, MUC6, and CD10. The results were correlated with morphologic categorization and clinicopathologic parameters. GED was classified as adenomatous, foveolar, or hybrid (showing features of both types), on the basis of histologic evaluation. The neighboring intestinal metaplasia (IM) was also evaluated. An adenomatous morphology was seen in 45%, hybrid type in 33.3%, and a "pure" foveolar type was seen in 21.7% of the cases. Foveolar GED was often depressed/flat on endoscopy and showed a statistically significant association with high-grade morphology (P = 0.046). Immunohistochemistry confirmed the histologic stratification. The foveolar and hybrid types were more often positive for MUC5AC (P = 0.0001 for both) and negative for CD10 (P = 0.019 and 0.016, respectively) as compared with adenomatous GED. High-grade morphology was associated with MUC5AC expression regardless of the morphologic phenotype (P = 0.026). Foveolar (73.3%) and hybrid (86.9%) GEDs were associated more often with IM showing a retained expression of gastric type mucin than adenomatous GED (29%) (P < 0.01 for both). In contrast, adenomatous type (58.1%) of GED was significantly associated with IM showing a complete intestinal phenotype (CD10+) compared with the foveolar (13.3%) and hybrid types (17.4%) of GED (P = 0.005 for both comparisons). In conclusion, our study indicates that foveolar and adenomatous types of GED have distinct clinicopathologic features, mucin profiles, and association with different types of IM. SN - 0147-5185 UR - https://www.unboundmedicine.com/medline/citation/18300795/Adenomatous_and_foveolar_gastric_dysplasia:_distinct_patterns_of_mucin_expression_and_background_intestinal_metaplasia_ L2 - http://dx.doi.org/10.1097/PAS.0b013e31815b890e DB - PRIME DP - Unbound Medicine ER -