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Scopul: Scopul studiului efectuat a fost acela de a estima prezenţa invaziei tumorale la nivelul vaselor limfatice, sanguine şi la nivel neural în carcinoamele gastrice pe preparatele colorate hematoxilină-eozină (H-E) şi, de asemenea, densitatea microvascularizatiei tumorale (MVD), detectată imunohistochimic, precum şi relaţia acestora cu parametrii clinico-patologici şi biologici ai tumorilor. Material şi metodă. Pentru evaluarea invaziei limfo-vasculare şi neurale am inclus în studiu 367 de pacienţi diagnosticaţi cu carcinoame gastrice. Pentru studiul imunohistochimic al MVD, au fost selectaţi 28 de pacienţi, din care 16 pacienţi cu gastrectomomie totală, în urma căreia s-a stabilit stadiul TNM al tumorii primare şi 12 pacienţi cu biopsie gastrică. Biopsiile gastrice şi probele chirurgicale au fost procesate folosind tehnica de includere la parafină şi coloraţia hematoxilină-eozină, iar pentru evaluarea imunohistochimică a MVD s-au utilizat anticorpii anti-CD31 şi anti-CD34. Rezultate: Prezenţa invaziei tumorale la nivelul vaselor sanguine a fost semnificativ asociată cu stadiile avansate de boală (p

Background: Lymph node ratio and lymph node status are the most important prognostic factors in the patients with gastric carcinoma, and the depth of wall invasion, and the prognostic significance of the histological type is unclear. The extent of stomach resection in gastric cancer depends on tumour size, tumour location, depth of invasion, and the histological allocation to intestinal or diffuse type according to Laurén. The aim of this study was to determine the prognostic value of the intestinal and diffuse histological types of gastric carcinoma, and of the well and poorly differentiated types. Material and method: In this study, we histopathologically assessed 252 patients with gastric cancer, by well and poorly differentiated type. Well differentiated carcinoma of the stomach included tubular and papillary adenocarcinomas, poorly differentiated medullary carcinoma, and well differentiated mucinous carcinoma (WDGC). For poorly differentiated carcinoma, we included the scirrhous carcinoma, signet ring cell carcinoma, and poorly differentiated mucinous gastric carcinoma (PDGC). Results: In the patients with PDGC, the tumour was located in the middle third of the stomach, with lymph node metastasis, serosal invasion (T3-T4), and peritoneal carcinomatosis (rarely). The patients with WDGC were with the tumour located in the lower third of the stomach, small tumour size and liver metastasis. The 5-year survival rate with serosa positive tumours, but with lymph node negative, was in WDGC of 32% vs. 28% in PDGC. p=0,086. The 5-year survival rate in the patients with serosa negative, but lymph node positive cancer, was of 28% in WDSC, vs. 29% in PDGC, p=0.008. The overall 5-year survival rate for the patients with WDGC was of 29% vs. 21% in PDGC. p=0,058, situation visible in tumours ≥ 10 cm, (21% vs. 14%, p=0,017). Multivariate analysis indicated that from the pathological point of view, tumour satus, histological type (WDGC vs. PDGC) were independent prognostic factors. Conclusions. Histological type is on indicator for tumour progression in gastric carcinoma. In the management of the gastric carcinoma, the histological type of tumour, (well and poorly differentiated), the depth of wall infiltration, and the status of the lymph node (N+,N-), as well as the size of the tumour (≥5cm, ≥10cm) should be evaluated. [ABSTRACT FROM AUTHOR]

Background: Lymph node ratio and lymph node status are the most important prognostic factors in the patients with gastric carcinoma, and the depth of wall invasion, and the prognostic significance of the histological type is unclear. The extent of stomach resection in gastric cancer depends on tumour size, tumour location, depth of invasion, and the histological allocation to intestinal or diffuse type according to Laurén. The aim of this study was to determine the prognostic value of the intestinal and diffuse histological types of gastric carcinoma, and of the well and poorly differentiated types. In this study, we histopathologically assessed 252 patients with gastric cancer, by well and poorly differentiated type. Well differentiated carcinoma of the stomach included tubular and papillary adenocarcinomas, poorly differentiated medullary carcinoma, and well differentiated mucinous carcinoma (WDGC). For poorly differentiated carcinoma, we included the scirrhous carcinoma, signet ring cell carcinoma, and poorly differentiated mucinous gastric carcinoma (PDGC). Results: In the patients with PDGC, the tumour was located in the middle third of the stomach, with lymph node metastasis, serosal invasion (T3-T4), and peritoneal carcinomatosis (rarely). The patients with WDGC were with tumour located in the lower third of the stomach, small tumour size and liver metastasis. The 5-year survival rate with serosa positive tumours, but with lymph node negative, was in WDGC of 32% vs. 28% in PDGC. p=0,086. The 5-year survival rate in the patients with serosa negative, but lymph node positive cancer, was of 28% in WDSC, vs. 29% in PDGC, p=0.008. The overall 5-year survival rate for the patients with WDGC was of 29% vs. 21% in PDGC. p=0,058, situation visible in tumours ≥ 10 cm, (21% vs. 14%, p=0,017). Multivariate analysis indicated that from the pathological point of view, tumour satus, histological type (WDGC vs. PDGC) were independent prognostic factors. Conclusions. Histological type is on indicator for tumour progression in gastric carcinoma. In the management of the gastric carcinoma, the histological type of tumour, (well and poorly differentiated), the depth of wall infiltration, and the status of the lymph node (N+,N-), as well as the size of the tumour (≥5cm, ≥10cm) should be evaluated. [ABSTRACT FROM AUTHOR]

Objective Angiogenesis in gastric tumor is a widely studied process, but recent clinical trials including anti-angiogenic drugs, do not show in all cases a significant increase in survival. Specific clinical and morphological criteria designed to select the cases with a high probability of response to these therapies are not yet established. Our study represents an early stage of observational analysis of the expression of vascular endothelial growth factor (VEGF-A) in gastric carcinomas. Material and method The study included 134 patients diagnosed with gastric cancer and who underwent a surgical intervention in order to remove the gastric tumor during 2008 - 2010. In every case there were analyzed: histological type, macroscopic aspect, location of carcinomas in the stomach, and pTNM staging. A number of 19 cases were selected and immunohistochemical examined for the expression of antibody anti-VEGF-A, clone VG1 produced by LabVision. Results In the cases of antral tumors, VEGF-A highly marked the absorptive cells of metaplasic peritumoral glands and the dysplasic glands, but it significantly decreased in tumor cells, independent of other clinical or pathological parameters. In the cases of body gastric carcinomas, peritumoral mucosa was focal positive without differences in intensity compared with tumor cells. Angiogenic immunophenotype did not correlate with any of the clinical and morphological parameters analyzed, regardless of location . Discussions The present study demonstrates that VEGF appears to have an important role in gastric carcinogenesis, especially in the early stages of antral tumors developed on the background of intestinal metaplasia. Conclusions Our study shows that the antral tumors seem to have a different angiogenic behavior from the gastric body tumors but the angiogenic immunophenotype does not correlate with tumor aggressiveness. VEGF plays an important role in early carcinogenesis, especially in areas with intestinal metaplasia. In order to make a proper interpretation of tumor angiogenesis in gastric carcinoma, prospective studies on large numbers of cases are needed. [ABSTRACT FROM AUTHOR]