GASTRIC MUCOUS NECK CELL AND INTESTINAL GOBLET CELL PHENOTYPES IN GASTRIC ADENOCARCINOMA

Aim-To investigate the phenotype of cells comprising diffuse and intes tinal-type gastric cancers using monoclonal antibodies to two antigens . One antigen (designated D10) is characteristic of gastric mucous nec k cells, cardiac glands, pyloric glands, and Brunner's glands. The sec ond antigen (designated 17NM) is specific to the mucous vacuole of int estinal goblet cells. Methods-Thirty two gastrectomy specimens with ad enocarcinoma were studied. Serial paraffin sections were stained immun ohistochemically for D10 and 17NM and histochemically for acid and neu tral mucins. The cancers were classified histologically as of either d iffuse or intestinal type according to Lauren. Results-Of 15 diffuse-t ype gastric carcinomas, 11 showed the majority of cancer cells stainin g for D10 while four were typical signet ring cell cancers staining pr edominantly for 17NM; five tumours displayed both phenotypes with the two phenotypes segregated in different areas of the tumours. In contra st, of 16 intestinal-type cancers, six expressed 17NM, three D10, five neither antigen, and two expressed both antigens. One indeterminate-t ype cancer expressed both antigens. The staining of individual cells f or D10 and 17NM was mutually exclusive in both diffuse and intestinal types. In contrast to the diffuse cancers, intestinal-type cancers typ ically expressed either antigen only in occasional small groups of cel ls and individual cells. Conclusions-In disease, the gastric stem cell can assume the capacity of the duodenal stem cell for divergent diffe rentiation into either intestinal goblet cells (for example, as in int estinal metaplasia) or Brunner's gland cells (for example, as in pylor ic gland/Brunner's gland metaplasia). With neoplastic transformation, this potential for divergent differentiation is maintained and gives r ise to diffuse-type cancers that display either the D10 phenotype, the 17NM phenotype, or the clonal expression of both phenotypes. more cel l cohesive (intestinal-type) tumours, differentiation for antigen expr ession is poorly developed and more frequently directed towards the in testinal goblet cell phenotype.