Given that previous studies indicated that early growth response 1 (EGR1) exerts pro-tumorigenic effects through regulating heparanase (HPA) transcription, it was hypothesized that EGR1 may correlate with the progression of gastric cancer. One hundred and fifteen patients with gastric cancer were evaluated for the protein and transcript expression of EGR1 and HPA on immunohistochemistry and real-time quantitative polymerase chain reaction (PCR). In normal gastric mucosa, EGR1 protein expression was absent or weak, whereas gastric cancer was positive for EGR1. Seventy gastric cancer patients (60.9%) were positive for cytoplasmic EGR1 expression, and 26 (22.6%) had nuclear expression of EGR1. In the gastric cancer examined, the transcripts of EGR1 were enhanced compared to that of normal gastric mucosa, and positively correlated with EGR1 protein expression. The cytoplasmic or nuclear expression of EGR1 and its transcripts in gastric cancer was positively correlated with tumor infiltration (P < 0.05), lymph node and distant metastasis (P < 0.05), tumor node metastasis (TNM) stages (P < 0.05), but not with age, gender, tumor location and size, histological types or differentiation. Moreover, the protein and transcript expression of EGR1 was correlated with that of HPA in gastric cancer. These results indicate that aberrant expression of EGR1 in gastric cancer is associated with tumor invasion and metastasis, and HPA transcription.

Introduction:Hepatoid adenocarcinoma (HAC) is a rare neoplasm with a striking morphologic similarity to hepatocellular carcinoma. The most common sites of HAC are the stomach, lung, and pancreas.Case report:Here we report a rare case of HAC arising from the heterotopic pancreas (Heinrich type II) in the ileum with lymph node metastasis. A 56-year-old man was admitted to our hospital presenting with bloody stools under no obvious predisposing causes. The colonoscopy and the gastroscopy showed no pathological findings. A computed tomography scan showed an intussusception of ileum. Then partial resection of ileum was performed with end-to-end anastomosis and appendectomy. Histopathological examination showed a malignant transformation of heterotopic pancreas (Heinrich type II) in the ileum. We made the diagnosis of HAC based on clinical pathological features and immunochemical staining. The patient received chemotherapy and died 9 months later.Conclusion:To our best knowledge, this is the first reported case of HAC originated from a heterotopic pancreas in the ileum. The clinical pathological features and immunochemical staining are important for correct diagnosis of HAC.