Detection and Characterization of Metastatic Cancer Cells in the Mesogastrium of Gastric Cancer Patients

Daxing Xie, Liang Liu, Hasan Osaiweran, Chaoran Yu, Fang Sheng, Chun Gao, Junbo Hu, Jianping Gong, Daxing Xie, Liang Liu, Hasan Osaiweran, Chaoran Yu, Fang Sheng, Chun Gao, Junbo Hu, Jianping Gong

Abstract

Gastric cancer is the second leading cause of cancer death worldwide. Here, we propose a novel type of tumor metastasis designated as Metastasis V in gastric cancer. Metastasis V is defined as the appearance of cancer cells in the mesogastrium with perigastric adipose tissue. To detect its incidence and characterize its clinic pathological features, large cross sectional tissue analysis of mesogastrium from 74 patients were used. Metastasis V was detected in 1 of 40 (2.5%) patients with early gastric cancer, 8 of 34 (24%) patients with advanced gastric cancer. The mean distance of Metastasis V from gastric wall was approximately 2.6 cm. Metastasis V was closely associated with tumor invasion depth, along with a number of positive lymph node metastasis. The prognosis of patients with Metastasis V was significantly (P<0.05) worse than those with tumor cell-free mesogastrium. These findings indicate that by using whole-sectional analysis, Metastasis V can be detected in the mesogastrium of gastric cancer patients, and also suggests that it may be a risk factor for patient survival after radical surgery.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1. Detection of Metastasis V in…
Fig 1. Detection of Metastasis V in gastric cancer patients.
(A) Large cross sectional tissue samples analysis of mesogastrium from surgically resected specimens. mLGEV, mRGEV, mLGV and mRGV were analyzed. (B) Continuous sections at 1-cm-width intervals of mesogastrium specimens. (C) Isolated cancer cells were detected in the mesogastrium of resected gastric cancer specimens by both HE staining (left) and immunohistochemistry with CK AE1/AE3 antibody (right). (D) Distance of Metastasis V from the gastric walls.
Fig 2. Schema of locational relationship between…
Fig 2. Schema of locational relationship between primary tumor and Metastasis V in nine patients with Metastasis V.
Fig 3. The overall survival of patients…
Fig 3. The overall survival of patients with or without Metastasis V.
(A) The Kaplan–Meier overall survival curves showed the prognosis of Metastasis V-positive patients was significantly (P = 0.006) worse than Metastasis V-negative patients. (B-C) Metastasis V-positive patients had a significantly poorer prognosis than Metastasis V-negative patients in the T3 subgroup (P = 0.004; B) or in clinical stage III (P = 0.0005; C).
Fig 4. E-cadherin and DAB2IP expression in…
Fig 4. E-cadherin and DAB2IP expression in normal gastric mucosa, primary gastric tumors and Metastasis V within the mesogastrium.
(A) Representative IHC staining for DAB2IP and E-cadherin from the same patient. (B) The relative quantitative analysis of E-cadherin and DAB2IP expression. One asterisk indicated statistical significance in normal mucosa vs. primary tumors (*, P

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