LI-cadherin: a marker of gastric metaplasia and neoplasia

Background-Intestinal metaplasia is considered a risk factor for the develo pment of gastric adenocarcinomas of the intestinal type and is found in app roximately 20% of gastric biopsies. Conventional histology only detects adv anced stages of intestinal metaplasia. Aims-To study expression of the enterocyte specific adhesion molecule liver -intestinal (LI)-cadherin in intestinal metaplasia as well as in gastric ca ncer, and to evaluate its use as a diagnostic marker molecule. Patients-Gastric biopsies (n=77) from 30 consecutive patients (n=30; aged 2 8-90 years) as well as surgically resected tissue samples (n=24) of all typ es of gastric carcinomas were analysed. Methods-Single and double label immunofluorescence detection on cryosection s of gastric biopsies; alkaline phosphatase antialkaline phosphatase method on paraffin embedded carcinoma tissue sections. Results-Of 77 biopsies (from 30 patients), 12 (from 10 patients) stained po sitive for LI-cadherin. LI-cadherin staining correlated with the presence o f intestinal metaplasia. Conventional histological diagnosis however failed to detect subtle gastric intestinal metaplasia (three of 10 patients). In contrast, only LI-cadherin and villin were positive in these cases whereas sucrase-isomaltase also failed to detect intestinal metaplasia in four of 1 0 patients. Well differentiated gastric carcinomas showed intense staining for LI-cadherin while undifferentiated carcinomas showed only weak diffuse cytoplasmic staining. Conclusions-To detect early metaplastic changes in the gastric mucosa, LI-c adherin has a sensitivity superior to sucrase-isomaltase and conventional h istology and comparable with that of villin. Its specificity exceeds that o f villin. Thus LI-cadherin represents a new, reliable, and powerful marker molecule for early detection of gastric intestinal metaplasia and well diff erentiated adenocarcinomas.