Lineage analysis of early and advanced tubular adenocarcinomas of the stomach: continuous or discontinuous?

<p>Abstract</p> <p>Background</p> <p>Eradication of early gastric carcinoma (GC) is thought to contribute to reduction in the mortality of GC, given that most of the early GCs progress to the advanced GCs. However, early GC is alternatively considered a dormant variant of GC, and it infrequently progresses to advanced GC. The aim of this study was to clarify the extent of overlap of genetic lineages between early and advanced tubular adenocarcinomas (TUBs) of the stomach.</p> <p>Methods</p> <p>Immunohistochemical staining for p53 was performed using 28 surgically resected stomachs with 13 intramucosal and 15 invasive TUBs. By chromosome- and array-based comparative genomic hybridization (CGH), genomic copy number constitution was compared between the mucosal and invasive parts of the invasive TUBs and between the mucosal parts of the invasive and intramucosal TUBs, using 25 and 22 TUBs, respectively. <it>TP53 </it>mutation in exons 5-8 was examined in 20 TUBs.</p> <p>Results</p> <p>Chromosomal CGH revealed that 4q+ and 11q+ were more common in advanced and early TUBs, respectively, whereas copy number changes in 8q and 17p showed no significant differences between early and advanced TUBs. However, array CGH revealed that, of the 13 intramucosal TUBs examined, loss of <it>MYC </it>(<it>MYC</it>-) and gain of <it>TP53 </it>(<it>TP53</it>+) was detected in 9 TUBs and <it>MYC</it>+ and/or <it>TP53</it>- was detected in 3 TUBs. Of the mucosal samples of 9 invasive TUBs, 7 showed <it>MYC</it>-/<it>TP53</it>+ and none showed <it>MYC</it>+ and/or <it>TP53</it>-. Of the 9 samples from the invasive parts, 1 (from submucosal cancers) showed <it>MYC</it>-/<it>TP53</it>+ and 6 (1 from submucosal and 5 from advanced cancers) showed <it>MYC</it>+ and/or <it>TP53</it>-. The latter 6 tumours commonly showed a mutant pattern (diffuse or null) in p53 immunohistochemistry, and 4 of the 6 tumours assessable for <it>TP53 </it>sequence analysis revealed mutations. The overall array CGH pattern indicated that, between the mucosal and invasive parts, genetic lineage was found discontinuous in 5 advanced cancers and continuous in 3 submucosal cancers.</p> <p>Conclusions</p> <p>Genetic lineages often differed between early and advanced TUBs. <it>MYC</it>-/<it>TP53</it>+ and <it>MYC </it>+ and/or <it>TP53</it>- may be the signatures of dormant and aggressive TUBs, respectively, in the stomach.</p