Yasemen ADALİ, Kenan BİNNETOĞLU, Hatice BEŞEREN, Hasan ÇANTAY, Turgut ANUK, Tülay DİKEN ALLAHVERDİ, Barlas SÜLÜ, Doğan GÖNÜLLÜ

Which Material Should Be Used for Mast Cell Evaluation in Gastric Cancer: Endoscopic Material or Resection Material?

Aim: Histopathological examination has an important place in the evaluation of parameters that are important in the prognosis of gastric tumors. In addition to the prognostic data included in the guidelines, other observed findings that may be important for the tumor behavior are also evaluated in the histopathological examination. Mast cells, which are among the elements of the immune system, are among these findings. In this study, it is aimed to compare the endoscopic biopsy materials and resection materials, which have the potential to be used for the evaluation of mast cells. Material and Method: Nineteen gastric tumor cases with endoscopic biopsy and resection material belonging to the same patient were included in the study. Toludine blue histochemistry was applied to the sections obtained from the paraffin blocks of the preparations representing the tumor. In the light microscopic evaluation, the area with the highest concentration of mast cells was selected at 100× magnification, and then 100 cells were counted inside and around the tumor at 400× magnification. Mast cells staining positively with toludine blue were noted in these 100 cells. Mann-Whitney-U was used in the analysis of the significance of mast cell number between groups, and Pearson’s test was used in the correlation between groups. Results: In the endoscopic biopsy material, the mean number of mast cells inside the tumor (MCIT) was 1.32±2.65, the mean number of mast cells around the tumor (MCAT) was 1.0±1.76; in the resection materials, the average number of MCIT was calculated as 4.84±4.86, and the average number of MCAT was calculated as 5.63±6.99. A statistically significant difference was observed between the number of MCIT (p=0.001) and the number of MCAT (p=0.000) between endoscopic biopsies and resection materials in the analyzes. When all the materials were included in analysis, it was determined that the number of MCIT and the number of MCAT showed a positive correlation. However, when endoscopic biopsies and resection materials were compared, it was noted that there was no correlation in terms of MCIT or MCAT. Conclusion: Mast cells, which are an important element of the immune response, are evaluated with different aspects in gastric cancers as in various tumors. Considering the importance of tumor and tumor microenvironment analysis as well as the results of the presented study, it is thought that mast cells, which have the potential to be an important marker in gastric tumors in the future, should be evaluated in the resection material, and endoscopic material evaluations do not reflect the real picture.

Keywords:

gastric cancer, mast cell, endoscopic biopsy, resection material,

PDF

___

1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68:394–424.
2. Saghier AA, Sagar M, Kabanja JH, Afreen S. Gastric Cancer: environmental risk factors, treatment and prevention. J Carcinogene Mutagene. 2013;14:354–9.
3. Jim MA, Pinheiro PS, Carreira H, Espey DK, Wiggins CL, Weir HK. Stomach cancer survival in the United States by race and stage (2001–2009): findings from the CONCORD-2 study. Cancer ACS J. 2017;123:4994–5013.
4. Kumar S, Metz DC, Ellenberg S, Kaplan DE, Goldberg DS. Risk factors and incidence of gastric cancer after detection of helicobacter pylori infection: a large cohort study. Gastroenterology. 2020;158(3):527–536.
5. Lyons K, Le LC, Pham YT, Borron C, Park JY, Tran CTD, et al. Gastric cancer: epidemiology, biology, and prevention: a mini review. Eur J Cancer Prev. 2019;28(5):397–412.
6. Zabaleta J. Multifactorial etiology of gastric cancer. Methods Mol Biol. 2012;863:411–35.
7. Subhash VV, Yeo MS, Tan WL, Yong WP. Strategies and advancements in harnessing the immune system for gastric cancer immunotherapy. J Immunol Res. 2015;2015:308574.
8. Rojas A, Araya P, Gonzalez I, Morales E. Gastric Tumor Microenvironment. Adv Exp Med Biol. 2020;1226:23–35.
9. Aponte-López A, Muñoz-Cruz S. Mast cells in the tumor microenvironment. Adv Exp Med Biol. 2020;1273:159–173.
10. Ribatti D, Guidolin D, Marzullo A, Nico B, Annese T, Benagiano V, et al. Mast cells and angiogenesis in gastric carcinoma. Int J Exp Pathol. 2010;91(4):350–6.
11. Hodges K, Kennedy L, Meng F, Alpini G, Francis H. Mast cells, disease and gastrointestinal cancer: A comprehensive review of recent findings. Transl Gastrointest Cancer. 2012;1(2):138150.
12. Zhong B, Li Y, Liu X, Wang D. Association of mast cell infiltration with gastric cancer progression. Oncol Lett. 2018;15(1):755–764.
13. Liu X, Jin H, Zhang G, Lin X, Chen C, Sun J, et al. Intratumor IL-17-positive mast cells are the major source of the IL-17 that is predictive of survival in gastric cancer patients. PLoS One. 2014;9(9):106–134.
14. Lin C, Liu H, Zhang H, Cao Y, Li R, Wu S, et al. Tryptase expression as a prognostic marker in patients with resected gastric cancer. Br J Surg. 2017;104(8):1037–1044.
15. Ammendola M, Sacco R, Donato G, Zuccalà V, Russo E, Luposella M, Vescio G, Rizzuto A, Patruno R, De Sarro G, Montemurro S, Sammarco G, Ranieri G. Mast cell positivity to tryptase correlates with metastatic lymph nodes in gastrointestinal cancer patients treated surgically. Oncology. 2013;85(2):111–6.
16. Karimi P, Islami F, Anandasabapathy S, Freedman ND, Kamangar F. Gastric cancer: descriptive epidemiology, risk factors, screening, and prevention. Cancer Epidemiol Biomarkers Prev. 2014;23(5):700–13.
17. Varricchi G, Galdiero MR, Loffredo S, Marone G, Iannone R, Marone G, Granata F. Are mast cells MASTers in cancer? Front Immunol. 2017;12;424–8.
18. Wang JT, Li H, Zhang H, Chen YF, Cao YF, Li RC, et al. Intratumoral IL17-producing cells infiltration correlate with antitumor immune contexture and improved response to adjuvant chemotherapy in gastric cancer. Ann Oncol. 2019;30(2):266–273.
19. Lv YP, Peng LS, Wang QH, Chen N, Teng YS, Wang TT, et al. Degranulation of mast cells induced by gastric cancer-derived adrenomedullin prompts gastric cancer progression. Cell Death Dis. 2018;9(10):1034.
20. Lv Y, Zhao Y, Wang X, Chen N, Mao F, Teng Y, et al. Increased intratumoral mast cells foster immune suppression and gastric cancer progression through TNF-α-PD-L1 pathway. J Immunother Cancer. 2019;7(1):54.
21. Micu GV, Stăniceanu F, Sticlaru LC, Popp CG, Bastian AE, Gramada E, Pop G, Mateescu RB, Rimbaş M, Archip B, Bleotu C. Correlations between the density of tryptase positive mast cells (DMCT) and that of new blood vessels (CD105+) in patients with gastric cancer. Rom J Intern Med. 2016;54(2):113–20.
22. Ammendola M, Sacco R, Sammarco G, Donato G, Zuccalà V, Romano R, et al. Mast cells positive to tryptase and c-kit receptor expressing cells correlates with angiogenesis in gastric cancer patients surgically treated. Gastroenterol Res Pract. 2013;2013:703163.