Spasmolytic polypeptide-expressing metaplasia (SPEM) associated with gastric cancer in Iceland

• Main Authors: Halldórsdóttir, Anna Margrét, Sigurdardóttrir, Margrét, Jónasson, Jón Gunnlaugur, Oddsdóttir, Margrét, Magnússon, Jónas, Lee, Jeffrey R, Goldenring, James R
• Other Authors: Department of Pathology, University Hospital of Iceland, Reykjavík.
• Format: Article in Journal/Newspaper
• Language: English
• Published: Springer Science + Business Media 2008
• Subjects: Adenocarcinoma; Adult; Aged; 80 and over; Antibodies; Monoclonal; Case-Control Studies; Female; Gastric Mucosa; Helicobacter Infections; Helicobacter pylori; Humans; Iceland; Immunohistochemistry; Male; Metaplasia; Middle Aged; Peptides; Precancerous Conditions; Stomach Neoplasms
• Online Access: http://hdl.handle.net/2336/15854; https://doi.org/10.1023/A:1022564027468

To access publisher full text version of this article. Please click on the hyperlink in Additional Links field Recent studies have described a spasmolytic polypeptide-expressing metaplastic cell lineage (SPEM) in the gastric fundic mucosa associated with both chronic H. pylori infection and gastric adenocarcinoma. We investigated the association of SPEM both with early gastric adenocarcinoma and in biopsies taken from patients prior to diagnosis of cancer. Two cohorts were examined. First, gastric resections from 29 patients with early gastric cancer were examined. Second, biopsies taken from 18 patients prior to the diagnosis of gastric cancer were compared with their respective resection specimens as well as with control biopsies from a cohort of 19 patients diagnosed with gastritis without subsequent development of cancer. The presence of SPEM and intestinal metaplasia (IM) adjacent to and distant from the cancer was compared and spasmolytic polypeptide (SP) immunostaining within dysplastic/cancerous cells was identified. SPEM was present adjacent to cancer in all early cancer cases where the tumor was located in the body or at the body/antrum junction, and was present in the body mucosa distant from the cancer in 76% of cases. Intestinal metaplasia was found adjacent to the tumor in 76% of cases and in body sections in 52% of resections. SP immunostaining was noted within cancer cells in 62% of tumors, and within dysplastic cells in 76% of resections where dysplasia was present. SPEM was present in 82% of the biopsies obtained prior to the diagnosis of cancer, compared with only 37% in the gastritis cohort. IM was present in only 57% of biopsies. In conclusion, SPEM is strongly associated with early gastric cancers and is observed in gastric biopsies prior to the development of cancer. In addition, early gastric cancers demonstrated a high incidence of SP expression. These results suggest that SPEM merits consideration as an important pre-neoplastic gastric lesion.