Does clear cell carcinoma of stomach exist? Clinicopathological and prognostic significance of clear cell changes in gastric adenocarcinomas. Issue 1 (14th March 2014)

• Record Type: Journal Article
• Authors: Kim, Joo‐Yeon; Park, Do Youn; Kim, Gwang Ha; Jeon, Tae‐Yong; Lauwers, Gregory Y
• Is Part Of: Histopathology. Volume 65:Issue 1(2014)
• Page Start: 90
• Page End: 99
• Publication Date: 2014-03-14
• Subjects: Histology, Pathological -- Periodicals; 611.018
• DOI: 10.1111/his.12372
• Languages: English
• ISSNs: 0309-0167

Abstract

<abstract abstract-type="main" id="his12372-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="his12372-sec-0001" sec-type="section"> <title>Aims</title> <p>In contrast to clear cell carcinomas developing in other organs (e.g. ovary and uterus), gastric adenocarcinomas with clear cell features are not well characterized.</p> </sec> <sec id="his12372-sec-0002" sec-type="section"> <title>Methods and results</title> <p>We evaluated a series of 762 gastric adenocarcinomas for the presence of clear cell changes; and investigated the nature of the changes using several histochemical and immunohistochemical markers, their association with various clinicopathological features, and their prognostic significance. Clear cell changes were observed in 8.5% (<italic>n </italic>=<italic> </italic>65) of gastric cancers. Cases with clear cell changes (GCC) were associated significantly with older age, intestinal type histology, body/fundic location, greater depth of invasion, lymph node metastases and lymphovascular invasion. An increasing proportion of clear cell changes indicated a worsening prognosis, and was identified as an independent marker of poor prognosis using the Cox proportional hazard model (hazard ratio, 0.462; <italic>P </italic>=<italic> </italic>0.003). Of 62 GCCs subjected to special staining, 35 cases (55.6%) displayed cytoplasmic accumulation of glycogen, while 21 (33.3%) contained mucin. GCCs showing glycogen accumulation expressed AFP, glypican‐3 and CD10 more commonly than those with mucin, which commonly expressed Muc5AC and Muc6.</p> </sec> <sec id="his12372-sec-0003" sec-type="section"> <title>Conclusion</title> <p>Clear cell gastric adenocarcinoma is a unique subgroup of gastric cancer which, although heterogeneous, has a poor prognosis.</p> </sec> </abstract>