LI-cadherin: a marker of gastric metaplasia and neoplasia

• Published in: Gut 2001-07, Vol.49 (1), p.73-81
• Main Authors: Grötzinger, C, Kneifel, J, Patschan, D, Schnoy, N, Anagnostopoulos, I, Faiss, S, Tauber, R, Wiedenmann, B, Geβner, R
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - metabolism; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Biomarkers, Tumor - metabolism; Biopsy; Blotting, Western; Cadherins; carcinogenesis; Carrier Proteins - metabolism; Diagnosis; Electrophoresis, Polyacrylamide Gel; Female; Fluorescent Antibody Technique, Indirect; Gastric Mucosa - metabolism; Gastric Mucosa - pathology; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Immunoblotting; intestinal metaplasia; Male; Medical sciences; Membrane Transport Proteins; Metaplasia; Metaplasia - metabolism; Microscopy, Fluorescence; Middle Aged; Paraffin Embedding; stomach; Stomach cancer; Stomach Neoplasms - metabolism; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Tumors
• ISSN: 0017-5749; 1468-3288; 1458-3288
• DOI: 10.1136/gut.49.1.73

BACKGROUND Intestinal metaplasia is considered a risk factor for the development of gastric adenocarcinomas of the intestinal type and is found in approximately 20% of gastric biopsies. Conventional histology only detects advanced stages of intestinal metaplasia. AIMS To study expression of the enterocyte specific adhesion molecule liver-intestinal (LI)-cadherin in intestinal metaplasia as well as in gastric cancer, and to evaluate its use as a diagnostic marker molecule. PATIENTS Gastric biopsies (n=77) from 30 consecutive patients (n=30; aged 28–90 years) as well as surgically resected tissue samples (n=24) of all types of gastric carcinomas were analysed. METHODS Single and double label immunofluorescence detection on cryosections of gastric biopsies; alkaline phosphatase antialkaline phosphatase method on paraffin embedded carcinoma tissue sections. RESULTS Of 77 biopsies (from 30 patients), 12 (from 10 patients) stained positive for LI-cadherin. LI-cadherin staining correlated with the presence of intestinal metaplasia. Conventional histological diagnosis however failed to detect subtle gastric intestinal metaplasia (three of 10 patients). In contrast, only LI-cadherin and villin were positive in these cases whereas sucrase-isomaltase also failed to detect intestinal metaplasia in four of 10 patients. Well differentiated gastric carcinomas showed intense staining for LI-cadherin while undifferentiated carcinomas showed only weak diffuse cytoplasmic staining. CONCLUSIONS To detect early metaplastic changes in the gastric mucosa, LI-cadherin has a sensitivity superior to sucrase-isomaltase and conventional histology and comparable with that of villin. Its specificity exceeds that of villin. Thus LI-cadherin represents a new, reliable, and powerful marker molecule for early detection of gastric intestinal metaplasia and well differentiated adenocarcinomas.