Annals of Surgical Oncology

, Volume 6, Issue 3, pp 290–297 | Cite as

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

  • W. Polkowski
  • J. W. van Sandick
  • G. J. A. Offerhaus
  • F. J. W. ten Kate
  • J. Mulder
  • H. Obertop
  • J. J. B. van Lanschot
Original Article


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 


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Copyright information

© The Society of Surgical Oncology, Inc. 1999

Authors and Affiliations

  • W. Polkowski
    • 1
    • 2
  • J. W. van Sandick
    • 1
  • G. J. A. Offerhaus
    • 2
  • F. J. W. ten Kate
    • 2
  • J. Mulder
    • 2
  • H. Obertop
    • 1
  • J. J. B. van Lanschot
    • 1
  1. 1.Departments of Surgery Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
  2. 2.Pathology Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands

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