© 2006 European Society for Medical Oncology
symposium article |
Gastric adenomas: relationship between clinicopathological findings, Helicobacter pylori infection, APC mutations and COX-2 expression
1 Department of Clinical and Experimental Medicine, Gastroenterology Unit, University Federico II, Naples; 2 Department of Human Pathology, 5 Department of Pediatric Sciences, 6 Department of Experimental Pathology and Microbiology, University of Messina, Messina; 3 Department of Oncology and Neurosciences, 7 Department of Gastroenterology, University G. d'Annunzio, Chieti; 4 Center of Excellence on Aging (CeSI), G. d'Annunzio University Foundation, Chieti; 8 Department of Experimental Medicine and Pathology, University La Sapienza, Rome; 9 Department of Oncology, Università di Palermo, Palermo; 10 Division of Medical Oncology, National Institute of Oncology, Bari, Italy
* Correspondence to: G. Nardone, Dipartimento di Medicina Clinica e Sperimentale, Unità di Gastroenterologia, Università degli Studi di Napoli ‘Federico II’, Via Pansini n° 5 80131 Napoli, Italy. Tel/Fax: +39-081-7464293; E-mail: nardone{at}unina.it
Gastric adenomas are rare neoplastic growths characterized by localized polypoid proliferations of dysplastic epithelium that tend to progress to infiltrating adenocarcinoma. Therefore, the identification of molecular markers that could reliably recognize adenomas at risk of progression is advocated in the clinical management. In this study we investigated, in a series of gastric adenoma specimens from an area at high risk of gastric cancer, the relationship between clinicopathological characteristics of adenoma and Helicobacter pylori infection, APC mutational status, and COX-2 and the down-stream enzyme mPGES1 expression. Helicobacter pylori infection, detected in 24%, and 33% by histology and PCR analyses, respectively, did not show any relationship with growth pattern, localization, size, dysplasia grade and presence of synchronous cancer. Pathogenetic mutations of MCR region (codons 1269–1589) of the APC gene were detected only in one case corresponding to a single, small size, low grade, H. pylori-negative adenoma. The expression of COX-2 largely matched that of mPGES1. Both were overexpressed in 79% of cases showing a relationship with high-grade dysplasia, size >10 mm and presence of a synchronous carcinoma. In conclusion, COX-2 may play a key role in the development and progression of gastric adenoma and could be an attractive target in the management of gastric adenoma at major risk of cancer development.
Key words: APC mutations, COX-2, gastric adenoma, Helicobacter pylori