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

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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.

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Authors and Affiliations

  1. Departments of Surgery Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands

    W. Polkowski MD, J. W. van Sandick MD, H. Obertop MD & J. J. B. van Lanschot MD

  2. Pathology Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    W. Polkowski MD, G. J. A. Offerhaus MD, F. J. W. ten Kate MD & J. Mulder BA

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  1. W. Polkowski MD
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  2. J. W. van Sandick MD
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  3. G. J. A. Offerhaus MD
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  4. F. J. W. ten Kate MD
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  5. J. Mulder BA
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  6. H. Obertop MD
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  7. J. J. B. van Lanschot MD
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WP, who was originally affiliated with the 2nd Department of General Surgery, Medical Academy (Lublin, Poland), is a fellow of the European Postgraduate Gastro-surgical School at the Academic Medical Center, University of Amsterdam (Amsterdam, The Netherlands).

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Polkowski, W., van Sandick, J.W., Offerhaus, G.J.A. et al. Prognostic Value of Laurén Classification and c-erbB-2 Oncogene Overexpression in Adenocarcinoma of the Esophagus and Gastroesophageal Junction. Ann Surg Oncol 6, 290–297 (1999). https://doi.org/10.1007/s10434-999-0290-2

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  • DOI: https://doi.org/10.1007/s10434-999-0290-2

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