Preoperative Estimation of Lymphatic Vessel Invasion on Gastric Carcinoma

Abstract

Preoperative estimation of lymphatic invasion by gastric carcinoma was attempted by using clinicopathological or cell and molecular biological methods. In 1129 cases of gastric carcinoma, the size of cancers with lymphatic invasion (71mm) was significantly (p<0.001) greater than that of cancers without lymphatic invasion (43mm). Stainability of nm23 was relatively low in cases of positive for lymphatic invasion. Simultaneous attempts to detect of proliferating cell nuclear antigen (PCNA) and numerical chromosomal aberrations were also performed in 100 cases of gastric carcinoma. PCNA was detected by the immunofluorescence method using anti-PCNA antibody (PC-10) after acetone-ethanol fixatin. Numerical chromosomal aberrations were detected by fluorescence in situ hybridization (FISH) using the probe for chromosome 17 centromere. The frequency of the cells with positive PCNA staining that had numerical aberration of chromosome 17 was significantly (p=0.0001) higher in the cases with lymphatic invasion (15.3%), compared to the cases without lymphatic invasion (9.0). The percentage of the cells that were PCNA-negative with numerical chromosomal aberrations was unrelated to lymphatic invasion. These results revealed that lymphatic vessel invasion is not induced by chromosome aberration or the cell cycle alone, but by a combination of both of them. This method can be performed preoperativeiy. The results also indicated that tumor size and tha rate of PCNA positivity with numerical aberration of chromosome 17 could be a marker for lymphatic invasion of gastric carcinoma.