Mucin expression in gastric- and gastro-oesophageal signet-ring cell cancer: results from a comprehensive literature review and a large cohort study of Caucasian and Asian gastric cancer
Background The literature on the prognostic relevance of signet-ring cell (SRC) histology in gastric cancer (GC) is controversial which is most likely related to inconsistent SRC classification based on haematoxylin–eosin staining. We hypothesised that mucin stains can consistently identify SRC-GC a...
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| Veröffentlicht in: | Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association 2020-09, Vol.23 (5), p.765-779 |
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| creator | Kerckhoffs, K. G. P. Liu, D. H. W. Saragoni, L. van der Post, R. S. Langer, R. Bencivenga, M. Iglesias, M. Gallo, G. Hewitt, L. C. Fazzi, G. E. Vos, A. M. Renaud, F. Yoshikawa, T. Oshima, T. Tomezzoli, A. de Manzoni, G. Arai, T. Kushima, R. Carneiro, F. Grabsch, H. I. |
| description | Background
The literature on the prognostic relevance of signet-ring cell (SRC) histology in gastric cancer (GC) is controversial which is most likely related to inconsistent SRC classification based on haematoxylin–eosin staining. We hypothesised that mucin stains can consistently identify SRC-GC and predict GC patient outcome.
Methods
We performed a comprehensive literature review on mucin stains in SRC-GC and characterised the mucin expression in 851 Caucasian GC and 410 Asian GC using Alcian Blue (AB)-Periodic Acid-Schiff (PAS), MUC2 (intestinal-type mucin), and MUC5AC (gastric-type mucin). The relationship between mucin expression and histological phenotype [poorly cohesive (PC) including proportion of SRCs, non-poorly cohesive (non-PC), or mucinous (MC)], clinicopathological variables, and patient outcome was analysed.
Results
Depending on mucin expression and cut-offs, the positivity rates of SRC-GC reported in the literature varied from 6 to 100%. Patients with MUC2 positive SRC-GC or SRC-GC with (gastro)intestinal phenotype had poorest outcome.
In our cohort study, PC with ≥ 10% SRCs expressed more frequently MUC2, MUC5AC, and ABPAS (
p
|
| doi_str_mv | 10.1007/s10120-020-01086-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7438382</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2435543675</sourcerecordid><originalsourceid>FETCH-LOGICAL-c568t-147c8c587d9f817a30588c2e28f23f84d0e54f794bf5724b058e6030029b7d8a3</originalsourceid><addsrcrecordid>eNp9ks2O1DAMxysEYpeFF-AUiQuXgpM0bcoBaTXiS1rEBc5RJnU7WbVJSdKBfTWejnQ6gODAwUos__yPY7sonlJ4QQGal5ECZVDCahRkXcK94pJWvC45B3H_15219KJ4FOMtABUtrR8WF5xVUtaCXhY_Pi7GOoLf54AxWu9I9gYdU7CmJNp1m-NLj9HPBz2gHkm0g8NUBusGYnAcidHOYHhFssYypkj64CeiifFTlj2gi_aIZLQJg05LwMwdLX47yWsy6jBgZg8-JBLT0t0R35OdXoyOVrsTdX26nes6P_e4eNDrMeKT83lVfHn75vPufXnz6d2H3fVNaUQtU0mrxkgjZNO1vaSNzq2R0jBksme8l1UHKKq-aat9LxpW7XMYa-AArN03ndT8qni96c7LfsLOoEtBj2oOdtLhTnlt1d8RZw9q8EfVVFxyybLA87NA8F8XjElNNq590w79EhWroKWtAC4y-uwf9NYvweXvZYoLkQfarBTbKBN8jAH738VQUOtqqG01FKy2roaCnMS3pDivg8PwR_o_WT8B6My-LQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2435543675</pqid></control><display><type>article</type><title>Mucin expression in gastric- and gastro-oesophageal signet-ring cell cancer: results from a comprehensive literature review and a large cohort study of Caucasian and Asian gastric cancer</title><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>SpringerNature Journals</source><creator>Kerckhoffs, K. G. P. ; Liu, D. H. W. ; Saragoni, L. ; van der Post, R. S. ; Langer, R. ; Bencivenga, M. ; Iglesias, M. ; Gallo, G. ; Hewitt, L. C. ; Fazzi, G. E. ; Vos, A. M. ; Renaud, F. ; Yoshikawa, T. ; Oshima, T. ; Tomezzoli, A. ; de Manzoni, G. ; Arai, T. ; Kushima, R. ; Carneiro, F. ; Grabsch, H. I.</creator><creatorcontrib>Kerckhoffs, K. G. P. ; Liu, D. H. W. ; Saragoni, L. ; van der Post, R. S. ; Langer, R. ; Bencivenga, M. ; Iglesias, M. ; Gallo, G. ; Hewitt, L. C. ; Fazzi, G. E. ; Vos, A. M. ; Renaud, F. ; Yoshikawa, T. ; Oshima, T. ; Tomezzoli, A. ; de Manzoni, G. ; Arai, T. ; Kushima, R. ; Carneiro, F. ; Grabsch, H. I.</creatorcontrib><description>Background
The literature on the prognostic relevance of signet-ring cell (SRC) histology in gastric cancer (GC) is controversial which is most likely related to inconsistent SRC classification based on haematoxylin–eosin staining. We hypothesised that mucin stains can consistently identify SRC-GC and predict GC patient outcome.
Methods
We performed a comprehensive literature review on mucin stains in SRC-GC and characterised the mucin expression in 851 Caucasian GC and 410 Asian GC using Alcian Blue (AB)-Periodic Acid-Schiff (PAS), MUC2 (intestinal-type mucin), and MUC5AC (gastric-type mucin). The relationship between mucin expression and histological phenotype [poorly cohesive (PC) including proportion of SRCs, non-poorly cohesive (non-PC), or mucinous (MC)], clinicopathological variables, and patient outcome was analysed.
Results
Depending on mucin expression and cut-offs, the positivity rates of SRC-GC reported in the literature varied from 6 to 100%. Patients with MUC2 positive SRC-GC or SRC-GC with (gastro)intestinal phenotype had poorest outcome.
In our cohort study, PC with ≥ 10% SRCs expressed more frequently MUC2, MUC5AC, and ABPAS (
p
< 0.001,
p
= 0.004 and
p
< 0.001, respectively). Caucasians with AB positive GC or combined ABPAS-MUC2 positive and MUC5AC negative had poorest outcome (all
p
= 0.002). This association was not seen in Asian patients.
Conclusions
This is the first study to suggest that mucin stains do not help to differentiate between SRC-GC and non-SRC-GC. However, mucin stains appear to be able to identify GC patients with different outcome. To our surprise, the relationship between outcome and mucin expression seems to differ between Caucasian and Asian GC patients which warrants further investigations.</description><identifier>ISSN: 1436-3291</identifier><identifier>EISSN: 1436-3305</identifier><identifier>DOI: 10.1007/s10120-020-01086-0</identifier><identifier>PMID: 32488651</identifier><language>eng</language><publisher>Singapore: Springer Singapore</publisher><subject>Abdominal Surgery ; Cancer Research ; Cohort analysis ; Esophagus ; Gastric cancer ; Gastroenterology ; Histology ; Intestine ; Literature reviews ; Medicine ; Medicine & Public Health ; Mucin ; Oncology ; Patients ; Phenotypes ; Review ; Review Article ; Surgical Oncology</subject><ispartof>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2020-09, Vol.23 (5), p.765-779</ispartof><rights>The Author(s) 2020</rights><rights>The Author(s) 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c568t-147c8c587d9f817a30588c2e28f23f84d0e54f794bf5724b058e6030029b7d8a3</citedby><cites>FETCH-LOGICAL-c568t-147c8c587d9f817a30588c2e28f23f84d0e54f794bf5724b058e6030029b7d8a3</cites><orcidid>0000-0001-9520-6228 ; 0000-0003-4583-8301</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10120-020-01086-0$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10120-020-01086-0$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids></links><search><creatorcontrib>Kerckhoffs, K. G. P.</creatorcontrib><creatorcontrib>Liu, D. H. W.</creatorcontrib><creatorcontrib>Saragoni, L.</creatorcontrib><creatorcontrib>van der Post, R. S.</creatorcontrib><creatorcontrib>Langer, R.</creatorcontrib><creatorcontrib>Bencivenga, M.</creatorcontrib><creatorcontrib>Iglesias, M.</creatorcontrib><creatorcontrib>Gallo, G.</creatorcontrib><creatorcontrib>Hewitt, L. C.</creatorcontrib><creatorcontrib>Fazzi, G. E.</creatorcontrib><creatorcontrib>Vos, A. M.</creatorcontrib><creatorcontrib>Renaud, F.</creatorcontrib><creatorcontrib>Yoshikawa, T.</creatorcontrib><creatorcontrib>Oshima, T.</creatorcontrib><creatorcontrib>Tomezzoli, A.</creatorcontrib><creatorcontrib>de Manzoni, G.</creatorcontrib><creatorcontrib>Arai, T.</creatorcontrib><creatorcontrib>Kushima, R.</creatorcontrib><creatorcontrib>Carneiro, F.</creatorcontrib><creatorcontrib>Grabsch, H. I.</creatorcontrib><title>Mucin expression in gastric- and gastro-oesophageal signet-ring cell cancer: results from a comprehensive literature review and a large cohort study of Caucasian and Asian gastric cancer</title><title>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association</title><addtitle>Gastric Cancer</addtitle><description>Background
The literature on the prognostic relevance of signet-ring cell (SRC) histology in gastric cancer (GC) is controversial which is most likely related to inconsistent SRC classification based on haematoxylin–eosin staining. We hypothesised that mucin stains can consistently identify SRC-GC and predict GC patient outcome.
Methods
We performed a comprehensive literature review on mucin stains in SRC-GC and characterised the mucin expression in 851 Caucasian GC and 410 Asian GC using Alcian Blue (AB)-Periodic Acid-Schiff (PAS), MUC2 (intestinal-type mucin), and MUC5AC (gastric-type mucin). The relationship between mucin expression and histological phenotype [poorly cohesive (PC) including proportion of SRCs, non-poorly cohesive (non-PC), or mucinous (MC)], clinicopathological variables, and patient outcome was analysed.
Results
Depending on mucin expression and cut-offs, the positivity rates of SRC-GC reported in the literature varied from 6 to 100%. Patients with MUC2 positive SRC-GC or SRC-GC with (gastro)intestinal phenotype had poorest outcome.
In our cohort study, PC with ≥ 10% SRCs expressed more frequently MUC2, MUC5AC, and ABPAS (
p
< 0.001,
p
= 0.004 and
p
< 0.001, respectively). Caucasians with AB positive GC or combined ABPAS-MUC2 positive and MUC5AC negative had poorest outcome (all
p
= 0.002). This association was not seen in Asian patients.
Conclusions
This is the first study to suggest that mucin stains do not help to differentiate between SRC-GC and non-SRC-GC. However, mucin stains appear to be able to identify GC patients with different outcome. To our surprise, the relationship between outcome and mucin expression seems to differ between Caucasian and Asian GC patients which warrants further investigations.</description><subject>Abdominal Surgery</subject><subject>Cancer Research</subject><subject>Cohort analysis</subject><subject>Esophagus</subject><subject>Gastric cancer</subject><subject>Gastroenterology</subject><subject>Histology</subject><subject>Intestine</subject><subject>Literature reviews</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mucin</subject><subject>Oncology</subject><subject>Patients</subject><subject>Phenotypes</subject><subject>Review</subject><subject>Review Article</subject><subject>Surgical Oncology</subject><issn>1436-3291</issn><issn>1436-3305</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><recordid>eNp9ks2O1DAMxysEYpeFF-AUiQuXgpM0bcoBaTXiS1rEBc5RJnU7WbVJSdKBfTWejnQ6gODAwUos__yPY7sonlJ4QQGal5ECZVDCahRkXcK94pJWvC45B3H_15219KJ4FOMtABUtrR8WF5xVUtaCXhY_Pi7GOoLf54AxWu9I9gYdU7CmJNp1m-NLj9HPBz2gHkm0g8NUBusGYnAcidHOYHhFssYypkj64CeiifFTlj2gi_aIZLQJg05LwMwdLX47yWsy6jBgZg8-JBLT0t0R35OdXoyOVrsTdX26nes6P_e4eNDrMeKT83lVfHn75vPufXnz6d2H3fVNaUQtU0mrxkgjZNO1vaSNzq2R0jBksme8l1UHKKq-aat9LxpW7XMYa-AArN03ndT8qni96c7LfsLOoEtBj2oOdtLhTnlt1d8RZw9q8EfVVFxyybLA87NA8F8XjElNNq590w79EhWroKWtAC4y-uwf9NYvweXvZYoLkQfarBTbKBN8jAH738VQUOtqqG01FKy2roaCnMS3pDivg8PwR_o_WT8B6My-LQ</recordid><startdate>20200901</startdate><enddate>20200901</enddate><creator>Kerckhoffs, K. G. P.</creator><creator>Liu, D. H. W.</creator><creator>Saragoni, L.</creator><creator>van der Post, R. S.</creator><creator>Langer, R.</creator><creator>Bencivenga, M.</creator><creator>Iglesias, M.</creator><creator>Gallo, G.</creator><creator>Hewitt, L. C.</creator><creator>Fazzi, G. E.</creator><creator>Vos, A. M.</creator><creator>Renaud, F.</creator><creator>Yoshikawa, T.</creator><creator>Oshima, T.</creator><creator>Tomezzoli, A.</creator><creator>de Manzoni, G.</creator><creator>Arai, T.</creator><creator>Kushima, R.</creator><creator>Carneiro, F.</creator><creator>Grabsch, H. I.</creator><general>Springer Singapore</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-9520-6228</orcidid><orcidid>https://orcid.org/0000-0003-4583-8301</orcidid></search><sort><creationdate>20200901</creationdate><title>Mucin expression in gastric- and gastro-oesophageal signet-ring cell cancer: results from a comprehensive literature review and a large cohort study of Caucasian and Asian gastric cancer</title><author>Kerckhoffs, K. G. P. ; Liu, D. H. W. ; Saragoni, L. ; van der Post, R. S. ; Langer, R. ; Bencivenga, M. ; Iglesias, M. ; Gallo, G. ; Hewitt, L. C. ; Fazzi, G. E. ; Vos, A. M. ; Renaud, F. ; Yoshikawa, T. ; Oshima, T. ; Tomezzoli, A. ; de Manzoni, G. ; Arai, T. ; Kushima, R. ; Carneiro, F. ; Grabsch, H. I.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c568t-147c8c587d9f817a30588c2e28f23f84d0e54f794bf5724b058e6030029b7d8a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Abdominal Surgery</topic><topic>Cancer Research</topic><topic>Cohort analysis</topic><topic>Esophagus</topic><topic>Gastric cancer</topic><topic>Gastroenterology</topic><topic>Histology</topic><topic>Intestine</topic><topic>Literature reviews</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mucin</topic><topic>Oncology</topic><topic>Patients</topic><topic>Phenotypes</topic><topic>Review</topic><topic>Review Article</topic><topic>Surgical Oncology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kerckhoffs, K. G. P.</creatorcontrib><creatorcontrib>Liu, D. H. W.</creatorcontrib><creatorcontrib>Saragoni, L.</creatorcontrib><creatorcontrib>van der Post, R. S.</creatorcontrib><creatorcontrib>Langer, R.</creatorcontrib><creatorcontrib>Bencivenga, M.</creatorcontrib><creatorcontrib>Iglesias, M.</creatorcontrib><creatorcontrib>Gallo, G.</creatorcontrib><creatorcontrib>Hewitt, L. C.</creatorcontrib><creatorcontrib>Fazzi, G. E.</creatorcontrib><creatorcontrib>Vos, A. M.</creatorcontrib><creatorcontrib>Renaud, F.</creatorcontrib><creatorcontrib>Yoshikawa, T.</creatorcontrib><creatorcontrib>Oshima, T.</creatorcontrib><creatorcontrib>Tomezzoli, A.</creatorcontrib><creatorcontrib>de Manzoni, G.</creatorcontrib><creatorcontrib>Arai, T.</creatorcontrib><creatorcontrib>Kushima, R.</creatorcontrib><creatorcontrib>Carneiro, F.</creatorcontrib><creatorcontrib>Grabsch, H. I.</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kerckhoffs, K. G. P.</au><au>Liu, D. H. W.</au><au>Saragoni, L.</au><au>van der Post, R. S.</au><au>Langer, R.</au><au>Bencivenga, M.</au><au>Iglesias, M.</au><au>Gallo, G.</au><au>Hewitt, L. C.</au><au>Fazzi, G. E.</au><au>Vos, A. M.</au><au>Renaud, F.</au><au>Yoshikawa, T.</au><au>Oshima, T.</au><au>Tomezzoli, A.</au><au>de Manzoni, G.</au><au>Arai, T.</au><au>Kushima, R.</au><au>Carneiro, F.</au><au>Grabsch, H. I.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mucin expression in gastric- and gastro-oesophageal signet-ring cell cancer: results from a comprehensive literature review and a large cohort study of Caucasian and Asian gastric cancer</atitle><jtitle>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association</jtitle><stitle>Gastric Cancer</stitle><date>2020-09-01</date><risdate>2020</risdate><volume>23</volume><issue>5</issue><spage>765</spage><epage>779</epage><pages>765-779</pages><issn>1436-3291</issn><eissn>1436-3305</eissn><abstract>Background
The literature on the prognostic relevance of signet-ring cell (SRC) histology in gastric cancer (GC) is controversial which is most likely related to inconsistent SRC classification based on haematoxylin–eosin staining. We hypothesised that mucin stains can consistently identify SRC-GC and predict GC patient outcome.
Methods
We performed a comprehensive literature review on mucin stains in SRC-GC and characterised the mucin expression in 851 Caucasian GC and 410 Asian GC using Alcian Blue (AB)-Periodic Acid-Schiff (PAS), MUC2 (intestinal-type mucin), and MUC5AC (gastric-type mucin). The relationship between mucin expression and histological phenotype [poorly cohesive (PC) including proportion of SRCs, non-poorly cohesive (non-PC), or mucinous (MC)], clinicopathological variables, and patient outcome was analysed.
Results
Depending on mucin expression and cut-offs, the positivity rates of SRC-GC reported in the literature varied from 6 to 100%. Patients with MUC2 positive SRC-GC or SRC-GC with (gastro)intestinal phenotype had poorest outcome.
In our cohort study, PC with ≥ 10% SRCs expressed more frequently MUC2, MUC5AC, and ABPAS (
p
< 0.001,
p
= 0.004 and
p
< 0.001, respectively). Caucasians with AB positive GC or combined ABPAS-MUC2 positive and MUC5AC negative had poorest outcome (all
p
= 0.002). This association was not seen in Asian patients.
Conclusions
This is the first study to suggest that mucin stains do not help to differentiate between SRC-GC and non-SRC-GC. However, mucin stains appear to be able to identify GC patients with different outcome. To our surprise, the relationship between outcome and mucin expression seems to differ between Caucasian and Asian GC patients which warrants further investigations.</abstract><cop>Singapore</cop><pub>Springer Singapore</pub><pmid>32488651</pmid><doi>10.1007/s10120-020-01086-0</doi><tpages>15</tpages><orcidid>https://orcid.org/0000-0001-9520-6228</orcidid><orcidid>https://orcid.org/0000-0003-4583-8301</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; SpringerNature Journals |
| subjects | Abdominal Surgery Cancer Research Cohort analysis Esophagus Gastric cancer Gastroenterology Histology Intestine Literature reviews Medicine Medicine & Public Health Mucin Oncology Patients Phenotypes Review Review Article Surgical Oncology |
| title | Mucin expression in gastric- and gastro-oesophageal signet-ring cell cancer: results from a comprehensive literature review and a large cohort study of Caucasian and Asian gastric cancer |
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