Original Article

Annals of Surgical Oncology

, Volume 6, Issue 3, pp 290-297

First online:

Prognostic Value of Laurén Classification and c-erbB-2 Oncogene Overexpression in Adenocarcinoma of the Esophagus and Gastroesophageal Junction

  • W. PolkowskiAffiliated withDepartments of Surgery Academic Medical Center, University of AmsterdamPathology Academic Medical Center, University of Amsterdam
  • , J. W. van SandickAffiliated withDepartments of Surgery Academic Medical Center, University of Amsterdam
  • , G. J. A. OfferhausAffiliated withPathology Academic Medical Center, University of Amsterdam
  • , F. J. W. ten KateAffiliated withPathology Academic Medical Center, University of Amsterdam
  • , J. MulderAffiliated withPathology Academic Medical Center, University of Amsterdam
  • , H. ObertopAffiliated withDepartments of Surgery Academic Medical Center, University of Amsterdam
  • , J. J. B. van LanschotAffiliated withDepartments of Surgery Academic Medical Center, University of Amsterdam

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Abstract

Background: The prognostic value of the Laurén classification and of c-erbB-2 oncogene overexpression has been described for gastric cancer. The aim of this study was to investigate the clinical significance of these factors in adenocarcinoma of the esophagus and/or gastroesophageal junction (GEJ).

Methods: Forty-one adenocarcinomas of the esophagus and/or GEJ were reviewed for tumor stage, lymph node status, Laurén classification, and c-erbB-2 overexpression, as assessed by immunohistochemical analysis.

Results: According to the Laurén classification, tumors were classified as intestinal-, mixed-, or diffuse-type (54%, 32%, and 15%, respectively). Diffuse-type tumors were associated with a significantly worse prognosis than were intestinal-type tumors (P = .018; log-rank test). The prognostic value of the Laurén classification was independent of stage (P = .048; Cox regression model). Overexpression of c-erbB-2 was detected in 24% of the tumors and was present exclusively in intestinal-type tumors and in intestinal-type areas of mixed-type tumors. Ten of the 30 stage III/IV tumors (33%) were c-erbB-2-positive, whereas none of the 11 stage I/II tumors (0%) overexpressed the oncogene product (P = .04; Fisher exact test). The prognostic value of c-erbB-2 overexpression was not independent of stage (P = .7; Cox regression model).

Conclusions: (1) The Laurén classification is an independent prognostic factor in adenocarcinoma of the esophagus and GEJ. (2) c-erbB-2 overexpression is limited to (areas of) intestinal-type tumors, indicating that intestinal- and diffuse-type tumors differ oncogenetically. (3) c-erbB-2 overexpression is associated with the stage of disease, indicating that it is a late event during tumor progression.

Key Words

Laurén classification C-erbB-2 oncogene Esophageal adenocarcinoma Prognosis