Prediction of Lymph Node Metastasis in Early Gastric Carcinoma by Immunohistochemical Analysis and its Clinical Application

Keisuke Matsusaki, Tomohiro Toda, Toyokazu Kawano, Osamu Miura, Yoshikazu Minamisono, Susumu Nagasaki, Wataru Yasui*

Department of Surgery, Hofu Institute of Gastroenterology
*First Department of Pathology, Hiroshima University School of Medicine

An immunohistochemical study was conducted by the ABC method for p53, c-erb B2, cyclin E and CD44 on formalin-fixed, paraffin-embedded slices obtained from 21 specimens of lymph node metastasis (n (+) group) from a total of 326 patients with early gastric cancer who underwent surgery between 1986 and 1995. The incidence of positive cases was compared with that in 40 controls (n (-) group). The incidence was significantly higher in the metastasis group than in the controls for p53, cyclin E and CD44. Thirty-three percent of the cases in the n (+) group and 8% of those in the n (-) group were positive for all three genes. All 7 of those who were strongly positive for cyclin E or CD44 were in the n (+) Group. Among the 29 patients who underwent surgery in 1996, four, including two with metastasis, were assessed as at high risk for lymph node metastasis based on the biopsy results. These findings indicate that consideration must be given to the fact that the risk of lymph node metastasis is extremely high in patients positive for p53, cyclin E and CD44, and that a judgement that can be used to assist in the selection of the most suitable therapy or surgery can be made prior to medical treatment at the time of biopy.

Key words
early gastric cancer, prediction of lymph node metastasis, cancer-related genes (p53, cyclin E, CD44), immunohistochemical analysis, clinical application

Reprint requests
Keisuke Matsusaki Department of Surgery, Hofu Institute of Gastroenterology
14-33 Ekiminami-machi, Hofu-city, 747-0801 JAPAN

Accepted
September 16, 1998

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