Prognostic value of Lauren 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. Jan B Van Lanschot

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The prognostic value of the Lauren 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, Lauren classification, and c-erbB-2 overexpression, as assessed by immunohistochemical analysis. Results: According to the Lauren 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 Lauren 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 Lauren 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.

Original languageEnglish (US)
Pages (from-to)290-297
Number of pages8
JournalAnnals of Surgical Oncology
Volume6
Issue number3
DOIs
StatePublished - Apr 1999
Externally publishedYes

Keywords

  • C-erbB-2 oncogene
  • Esophageal adenocarcinoma
  • Lauren classification
  • Prognosis

ASJC Scopus subject areas

  • Surgery
  • Oncology

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