Geographic particularities in incidence and etiopathogenesis of sporadic gastric cancer

Kádár, Zoltán; Jung, Ioan; Orłowska, Janina; Szentirmay, Zoltán; Sugimura, Haruhiko; Turdean, Sabin Gligore; Gurzu, Simona

doi:10.5114/pjp.2015.54959

Cited by 18 publications

(23 citation statements)

References 43 publications

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“…This tendency seems to be related to the economic aspects; the distally located tumors are more frequent in developing countries, in contrast to proximal ones found more frequently in Northern Europe 1 11. The proximally located GCs are more frequent in white patients 1 6 11…”

Section: Discussionmentioning

confidence: 98%

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Proposal of a Dukes-Mac-Like Staging System for Gastric Cancer

Gurzu

Sugimura

Orłowska

et al. 2017

Journal of Investigative Medicine

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The aim of this study was to present an epidemiological update regarding the classical prognostic parameters of gastric cancer (GC) in 3 countries from Eastern Europe and to suggest a modification of the pTNM staging system. In 333 consecutive cases which were diagnosed between 2003 and 2012 in 3 departments of pathology from Romania, Hungary, and Poland, the following parameters were analyzed: age and gender of patients, tumor localization, macroscopic and microscopic aspects including the degree of discohesivity, depth of tumor infiltration, and pTNM stage. From all of the studied parameters, the following proved to have independent prognostic value, indicating a lower survival rate: presence of distant metastases (p=0.001), lymph node positivity (p=0.0009), depth of tumor infiltration (p=0.04), age over 50 (p=0.02), proximally located tumors (p=0.03), and ulceroinfiltrative or diffusely infiltrative macroscopic aspect (p=0.0002). The pT2N1-3 staged cases showed a worse prognosis compared with the pT3N0 ones (p=0.02). Regardless of depth of invasion, the lymph node status remains the strongest indicator of the survival rate in GC. The pTN staging system should be adapted and a Dukes-MAC-like staging system should include the following groups: stage A1-T1N0, stage A2-T1N1-3, stage B1-T2N0, stage B2-T2N1-3, stage C1-T3N0, stage C2-T3N1-3, and stage D-T4N0-3. The grade of discohesivity/budding is not a prognostic factor in GC.

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Section: Discussionmentioning

confidence: 98%

“…However, the intestinal-type GCs seem to be predominant in the gastric body and also the most frequent histological type in Eastern Europe 1 11 12. They are also more frequent in black patients than in white patients 1 6 11…”

Section: Discussionmentioning

confidence: 99%

Proposal of a Dukes-Mac-Like Staging System for Gastric Cancer

Gurzu

Sugimura

Orłowska

et al. 2017

Journal of Investigative Medicine

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“…The TP53 mutation rate was proved to be dependent by various parameters, including geographic characteristics known to be induced by interactions between Helicobacter pylori infection and other environmental, molecular and genetic factors[ 13 , 15 , 16 ]. In our study, which included Romanian patients, the mutation rate was 33.83%, similar to American Caucasian (40%) and Hispanic patients (43%), whereas Asian and African American patients, similar to patients in Bangladesh, proved to have significantly elevated mutations rates of 56%, 89%, and 73%, respectively[ 16 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

Maspin subcellular expression in wild-type and mutant TP53 gastric cancers

Gurzu¹,

Jung²,

Sugimura³

et al. 2020

WJGO

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BACKGROUND Although the role of p53 in the evolution and prognosis of gastric cancer (GC) has been extensively examined, the exact mechanism of action is incompletely understood. In the last years, p53-target genes were supposed to be involved in the p53 pathway. One of them is the tumor-suppressor gene Maspin, which codifies the protein with the same name. Maspin activity depends on its subcellular localization. To our knowledge, the possible role of TP53 gene in Maspin subcellular localization, in GC cells, has not yet been studied in a large number of human samples. AIM To evaluate the possible role of wild-type and mutated p53 in Maspin subcellular localization. METHODS The present study included 266 consecutive patients with GC in which TP53 gene status, and mutations in exons 2 to 11, respectively, were analyzed and correlated with immunohistochemical expression of p53 and Maspin. RESULTS None of the 266 cases showed mutations in exon 9. The rate of TP53 mutations was 33.83%. The mutation rate was slightly higher in distally-located GCs, with a lower degree (≤ 5 buds/ high power fields) of dyscohesivity ( P < 0.01). The wild-type cases had a longer survival, compared with mutant GCs, especially in patients without lymph node metastases, despite the high depth of tumor infiltration ( P = 0.01). The Dukes-MAC-like staging system was proved to have the most significant independent prognostic value ( P < 0.01). The statistical correlations proved that TP53 gene mutations in exon 7 might induce knockdown of Maspin, but wild-type p53 can partially restore nuclear Maspin expression and decrease the metastatic potential of gastric adenocarcinoma cells. CONCLUSION Downregulated Maspin might be induced by mutations in exon 7 of the TP53 gene but wild-type p53 can partially restore nuclear Maspin expression. These findings should be proved in experimental studies.

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“…In Poland, the 5-year relative survival rate was 12.94/100,000 in male patients and 4.68/100,000 in female patients. [ 38 ]…”

Section: Discussionmentioning

confidence: 99%

Impact on long-term survival of the number of lymph nodes resected in patients with pT1N0 gastric cancer after R0 resection

Zhao

Kan

et al. 2016

Medicine

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Although studies on the association between the number of lymph nodes resected and prognosis in patients with pT2–4N0 stages of gastric cancer have reported consistent results, there is no consensus on the optimal number of lymph nodes to be examined for pT1N0 stage gastric cancer. The aim of this study was to evaluate the long-term effect of the number of lymph nodes removed on the outcomes of patients with pT1N0 stage gastric cancer after R0 resection.From December 2009 to December 2011, 227 patients undergoing R0 resection of pT1N0 stage gastric cancer at 4 Chinese centers were enrolled in this study. Patients were assigned to 2 groups according to the number of lymph nodes dissected (≤15 or > 15). Standard survival methods and restricted multivariable Cox regression models were applied.More women (P = 0.031) were in the ≤15 group than in the >15 group. The mean number of lymph nodes removed from women was greater than that from men (P = 0.007). The 5-year survival rate was significantly higher in the >15 lymph nodes resected group than the ≤15 group. The number of lymph nodes resected was identified as an independent prognostic factor and was significantly correlated with overall survival (OS).A lymphadenectomy with dissection of more than 15 lymph nodes improved the long-term survival of patients with pT1N0 gastric cancer after R0 resection. Therefore, it is necessary to consider removing more than 15 lymph nodes among such patients.

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Geographic particularities in incidence and etiopathogenesis of sporadic gastric cancer

Cited by 18 publications

References 43 publications

Proposal of a Dukes-Mac-Like Staging System for Gastric Cancer

Proposal of a Dukes-Mac-Like Staging System for Gastric Cancer

Maspin subcellular expression in wild-type and mutant TP53 gastric cancers

Impact on long-term survival of the number of lymph nodes resected in patients with pT1N0 gastric cancer after R0 resection

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