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Hayasaka J, Inoshita N, Suzuki Y, et al. Pepsinogen I- and H+/K+-ATPase-immunohistochemical Positivity in Endoscopically Resected Early Gastric Neoplasia. Am J Surg Pathol. 2022;doi: 10.1097/PAS.0000000000001861.
Hayasaka, J., Inoshita, N., Suzuki, Y., Nomura, K., Odagiri, H., Ochiai, Y., Tanaka, M., Yamashita, S., Matsui, A., Kikuchi, D., Kitagawa, M., & Hoteya, S. (2022). Pepsinogen I- and H+/K+-ATPase-immunohistochemical Positivity in Endoscopically Resected Early Gastric Neoplasia. The American journal of surgical pathology, . https://doi.org/10.1097/PAS.0000000000001861
Hayasaka, Junnosuke, et al. "Pepsinogen I- and H+/K+-ATPase-immunohistochemical Positivity in Endoscopically Resected Early Gastric Neoplasia." The American journal of surgical pathology vol. (2022). doi: https://doi.org/10.1097/PAS.0000000000001861
Hayasaka J, Inoshita N, Suzuki Y, Nomura K, Odagiri H, Ochiai Y, Tanaka M, Yamashita S, Matsui A, Kikuchi D, Kitagawa M, Hoteya S. Pepsinogen I- and H+/K+-ATPase-immunohistochemical Positivity in Endoscopically Resected Early Gastric Neoplasia. Am J Surg Pathol. 2022 Jan 10; doi: 10.1097/PAS.0000000000001861. Epub 2022 Jan 10. PMID: 34999591.
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Am J Surg Pathol. 2022 Jan 10; doi: 10.1097/PAS.0000000000001861. Epub 2022 Jan 10.

Pepsinogen I- and H+/K+-ATPase-immunohistochemical Positivity in Endoscopically Resected Early Gastric Neoplasia.

The American journal of surgical pathology

Junnosuke Hayasaka, Naoko Inoshita, Yugo Suzuki, Kosuke Nomura, Hiroyuki Odagiri, Yorinari Ochiai, Masami Tanaka, Satoshi Yamashita, Akira Matsui, Daisuke Kikuchi, Masanobu Kitagawa, Shu Hoteya

Affiliations

  1. Departments of Gastroenterology Pathology, Toranomon Hospital Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University Department of Pathology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan.

PMID: 34999591 DOI: 10.1097/PAS.0000000000001861

Abstract

Gastric adenocarcinoma of the fundic gland type (GAFG) has been recently classified by the World Health Organization (WHO), however, clinicopathologic features of pepsinogen I- or H+/K+-ATPase-positive gastric tumors remain unclear. Therefore, this study evaluates the frequency and clinicopathologic features of those tumors, using a tissue microarray block to identify pepsinogen I- or H+/K+-ATPase-positive tumors from 810 endoscopically resected, early gastric epithelial tumors. The frequency of pepsinogen I-positive lesions was 2.1%, and that of H+/K+-ATPase-positive lesions was 2.0%. Pepsinogen I- or H+/K+-ATPase positivity was not observed in undifferentiated-type tumors, while gastric tumors with morphologic similarity to fundic glands were positive for pepsinogen I- or H+/K+-ATPase. We divided pepsinogen I- or H+/K+-ATPase-positive gastric tumors into group A, with fundic gland-like structure, or group B, without fundic gland-like structure. The frequency of group A was 1.6%: 46.2% were positive only for pepsinogen I and 53.8% for H+/K+-ATPase and pepsinogen I. The frequency of group B was 1.5%: 25% were positive only for pepsinogen I, 8.3% for H+/K+-ATPase and pepsinogen I, and 66.7% only for H+/K+-ATPase. The 2 tumor groups differed in location and endoscopic features. Hematoxylin and eosin staining showed that group B had more exposed tumors to the surface, larger nuclei, and more background atrophy than group A. Immunostaining showed significantly higher positivity rates for MUC5AC, CD10, CDX2, and p53 expression, and a higher Ki-67 labeling score. Our results provide novel insights into the pathology of early gastric tumors with histologic or immunohistochemical evidence of fundic gland differentiation.

Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

Conflict of interest statement

Conflicts of Interest and Source of Funding: J.H. received a grant from Toranomon Hospital. N.I. and S.H. received a grant from Okinaka Memorial Institute of Medical Research. For the remaining author

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