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

Xie D, Liu L, Osaiweran H, Yu C, Sheng F, Gao C, Hu J, Gong J - PLoS ONE (2015)

Bottom Line: Gastric cancer is the second leading cause of cancer death worldwide.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.

View Article: PubMed Central - PubMed

Affiliation: Tongji Cancer Research Institute, Tongji Hospital, Tongji Medical College in Huazhong University of Science and Technology, Wuhan, Hubei, China.

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.

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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.
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pone.0142970.g001: 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.

Mentions: Direct invasion, lymphatic drainage, hematogenous spread and peritoneal dissemination are the four classical routes through which local-regional recurrence or distant implants of gastric cancer cells can be determined. Each of these pathways is located in the particular cavity. For example, the direct invasion and peritoneal spread are located in the serous cavity; hematogenous metastasis can be found in blood vessel cavities; in lymphatic metastasis, the cancer cells are located in the cavities of lymphatic vessels and nodes. However, in addition to these pathways, people have also reported different metastatic cancer cells in local perigastric adipose tissues[7–11]. Since they failed to describe the cavity these tissues were located in, metastasis has been explained as a chance occurrence, occasional event, or one confused with an underlying serous spread. The “envelop” hypothesis of mesogastrium was proposed when a previously unidentified cavity, surrounded or enveloped by proper fascia, was discovered with cancer cells located and moving in it[12]. We designated the appearance of these cancer cells in the mesogastrium with perigastric adipose tissue as Metastasis V[12]. To confirm our hypothesis, we further detected the incidence and characterized the pathological characteristics of Metastasis V by using large cross sectional tissue samples of mesogastrium obtained from gastric cancer patients. A total of 5,892 mesogastrium samples sections, each with a thickness of 4 μm, from 74 patients were analyzed (Fig 1A and 1B).


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

Xie D, Liu L, Osaiweran H, Yu C, Sheng F, Gao C, Hu J, Gong J - PLoS ONE (2015)

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.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4643961&req=5

pone.0142970.g001: 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.
Mentions: Direct invasion, lymphatic drainage, hematogenous spread and peritoneal dissemination are the four classical routes through which local-regional recurrence or distant implants of gastric cancer cells can be determined. Each of these pathways is located in the particular cavity. For example, the direct invasion and peritoneal spread are located in the serous cavity; hematogenous metastasis can be found in blood vessel cavities; in lymphatic metastasis, the cancer cells are located in the cavities of lymphatic vessels and nodes. However, in addition to these pathways, people have also reported different metastatic cancer cells in local perigastric adipose tissues[7–11]. Since they failed to describe the cavity these tissues were located in, metastasis has been explained as a chance occurrence, occasional event, or one confused with an underlying serous spread. The “envelop” hypothesis of mesogastrium was proposed when a previously unidentified cavity, surrounded or enveloped by proper fascia, was discovered with cancer cells located and moving in it[12]. We designated the appearance of these cancer cells in the mesogastrium with perigastric adipose tissue as Metastasis V[12]. To confirm our hypothesis, we further detected the incidence and characterized the pathological characteristics of Metastasis V by using large cross sectional tissue samples of mesogastrium obtained from gastric cancer patients. A total of 5,892 mesogastrium samples sections, each with a thickness of 4 μm, from 74 patients were analyzed (Fig 1A and 1B).

Bottom Line: Gastric cancer is the second leading cause of cancer death worldwide.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.

View Article: PubMed Central - PubMed

Affiliation: Tongji Cancer Research Institute, Tongji Hospital, Tongji Medical College in Huazhong University of Science and Technology, Wuhan, Hubei, China.

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.

Show MeSH
Related in: MedlinePlus