Comparative histochemical evaluation of mucins expression in fetal esophagus and adenocarcinomas of the gastroesophageal junction
Aim: To study and compare the expression patterns of mucins in the fetal gastroesophageal junction (GEJ) region and adenocarcinomas of the GEJ in adults using histochemical method. Material and Methods: To reveal the expression of different mucins, tissue sections from formalin-fixed paraffin-embedd...
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irk-123456789-1455862019-01-25T01:23:16Z Comparative histochemical evaluation of mucins expression in fetal esophagus and adenocarcinomas of the gastroesophageal junction Vernygorodskyi, S. Rekun, T. Zhuchenko, P. Reviews Aim: To study and compare the expression patterns of mucins in the fetal gastroesophageal junction (GEJ) region and adenocarcinomas of the GEJ in adults using histochemical method. Material and Methods: To reveal the expression of different mucins, tissue sections from formalin-fixed paraffin-embedded tissue blocks of fetal GEJ and carcinomas of GEJ were stained by the following histological stains: hematoxylin and eosin, periodic acid-Schiff (PAS), alcian blue (AB), pH 2.5, combined AB-PAS, and combined AB-Aldehyde Fuchsin (AB/AF). Results: Expression of mucins within the developing fetal GEJ has been demonstrated (gestational age 5–38 weeks). We studied histochemical features of neoplastic cells in carcinomas of GEJ from 90 adult patients. The results showed that in gastric type expression of neutral mucins dominated especially in well differentiated (G1) adenocarcinomas and corresponded to the last three months of GEJ development, while in the intestinal and mixed type significant acid mucins expression was detected in moderate (G2) and poorly (G3) differentiated adenocarcinomas and corresponded to 17–25 weeks of GA. No significant coincidence in mucins expression was observed in signet ring cell carcinomas in relation to GA. Conclusion: Our data suggest that decrease of neutral mucins level can be considered reliable phenotypic marker of poor prognosis of GEJ adenocarcinomas. Study of the developmental expression of mucin genes may improve understanding of the malignant transformation of esophageal tissue. Key Words: mucin expression, gastroesophageal junction, adenocarcinoma. 2018 Article Comparative histochemical evaluation of mucins expression in fetal esophagus and adenocarcinomas of the gastroesophageal junction / S. Vernygorodskyi, T. Rekun, P. Zhuchenko // Experimental Oncology. — 2018 — Т. 40, № 2. — С. 223-227. — Бібліогр.: 21 назв. — англ. 1812-9269 http://dspace.nbuv.gov.ua/handle/123456789/145586 en Experimental Oncology Інститут експериментальної патології, онкології і радіобіології ім. Р.Є. Кавецького НАН України |
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Reviews Reviews Vernygorodskyi, S. Rekun, T. Zhuchenko, P. Comparative histochemical evaluation of mucins expression in fetal esophagus and adenocarcinomas of the gastroesophageal junction Experimental Oncology |
| description |
Aim: To study and compare the expression patterns of mucins in the fetal gastroesophageal junction (GEJ) region and adenocarcinomas of the GEJ in adults using histochemical method. Material and Methods: To reveal the expression of different mucins, tissue sections from formalin-fixed paraffin-embedded tissue blocks of fetal GEJ and carcinomas of GEJ were stained by the following histological stains: hematoxylin and eosin, periodic acid-Schiff (PAS), alcian blue (AB), pH 2.5, combined AB-PAS, and combined AB-Aldehyde Fuchsin (AB/AF). Results: Expression of mucins within the developing fetal GEJ has been demonstrated (gestational age 5–38 weeks). We studied histochemical features of neoplastic cells in carcinomas of GEJ from 90 adult patients. The results showed that in gastric type expression of neutral mucins dominated especially in well differentiated (G1) adenocarcinomas and corresponded to the last three months of GEJ development, while in the intestinal and mixed type significant acid mucins expression was detected in moderate (G2) and poorly (G3) differentiated adenocarcinomas and corresponded to 17–25 weeks of GA. No significant coincidence in mucins expression was observed in signet ring cell carcinomas in relation to GA. Conclusion: Our data suggest that decrease of neutral mucins level can be considered reliable phenotypic marker of poor prognosis of GEJ adenocarcinomas. Study of the developmental expression of mucin genes may improve understanding of the malignant transformation of esophageal tissue. Key Words: mucin expression, gastroesophageal junction, adenocarcinoma. |
| format |
Article |
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Vernygorodskyi, S. Rekun, T. Zhuchenko, P. |
| author_facet |
Vernygorodskyi, S. Rekun, T. Zhuchenko, P. |
| author_sort |
Vernygorodskyi, S. |
| title |
Comparative histochemical evaluation of mucins expression in fetal esophagus and adenocarcinomas of the gastroesophageal junction |
| title_short |
Comparative histochemical evaluation of mucins expression in fetal esophagus and adenocarcinomas of the gastroesophageal junction |
| title_full |
Comparative histochemical evaluation of mucins expression in fetal esophagus and adenocarcinomas of the gastroesophageal junction |
| title_fullStr |
Comparative histochemical evaluation of mucins expression in fetal esophagus and adenocarcinomas of the gastroesophageal junction |
| title_full_unstemmed |
Comparative histochemical evaluation of mucins expression in fetal esophagus and adenocarcinomas of the gastroesophageal junction |
| title_sort |
comparative histochemical evaluation of mucins expression in fetal esophagus and adenocarcinomas of the gastroesophageal junction |
| publisher |
Інститут експериментальної патології, онкології і радіобіології ім. Р.Є. Кавецького НАН України |
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2018 |
| topic_facet |
Reviews |
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http://dspace.nbuv.gov.ua/handle/123456789/145586 |
| citation_txt |
Comparative histochemical evaluation of mucins expression in fetal esophagus and adenocarcinomas of the gastroesophageal junction / S. Vernygorodskyi, T. Rekun, P. Zhuchenko // Experimental Oncology. — 2018 — Т. 40, № 2. — С. 223-227. — Бібліогр.: 21 назв. — англ. |
| series |
Experimental Oncology |
| work_keys_str_mv |
AT vernygorodskyis comparativehistochemicalevaluationofmucinsexpressioninfetalesophagusandadenocarcinomasofthegastroesophagealjunction AT rekunt comparativehistochemicalevaluationofmucinsexpressioninfetalesophagusandadenocarcinomasofthegastroesophagealjunction AT zhuchenkop comparativehistochemicalevaluationofmucinsexpressioninfetalesophagusandadenocarcinomasofthegastroesophagealjunction |
| first_indexed |
2025-07-10T22:00:07Z |
| last_indexed |
2025-07-10T22:00:07Z |
| _version_ |
1837298968642453504 |
| fulltext |
Experimental Oncology ��� �������� ���� ��eptem�er���� �������� ���� ��eptem�er� ��eptem�er� ���
COMPARATIVE HISTOCHEMICAL EVALUATION OF MUCINS
EXPRESSION IN FETAL ESOPHAGUS AND ADENOCARCINOMAS
OF THE GASTROESOPHAGEAL JUNCTION
S. Vernygorodskyi*, T. Rekun, P. Zhuchenko
Department of Pathological Anatomy, Forensic Medicine and Law, National Pirogov Memorial Medical
University, Vinnytsia, Ukraine
Aim: To study and compare the expression patterns of mucins in the fetal gastroesophageal junction (GEJ) region and adenocarci-
nomas of the GEJ in adults using histochemical method. Material and Methods: To reveal the expression of different mucins, tissue
sections from formalin-fixed paraffin-embedded tissue blocks of fetal GEJ and carcinomas of GEJ were stained by the following
histological stains: hematoxylin and eosin, periodic acid-Schiff (PAS), alcian blue (AB), pH 2.5, combined AB-PAS, and combined
AB-Aldehyde Fuchsin (AB/AF). Results: Expression of mucins within the developing fetal GEJ has been demonstrated (gestational
age 5–38 weeks). We studied histochemical features of neoplastic cells in carcinomas of GEJ from 90 adult patients. The results
showed that in gastric type expression of neutral mucins dominated especially in well differentiated (G1) adenocarcinomas and cor-
responded to the last three months of GEJ development, while in the intestinal and mixed type significant acid mucins expression was
detected in moderate (G2) and poorly (G3) differentiated adenocarcinomas and corresponded to 17–25 weeks of GA. No significant
coincidence in mucins expression was observed in signet ring cell carcinomas in relation to GA. Conclusion: Our data suggest that
decrease of neutral mucins level can be considered reliable phenotypic marker of poor prognosis of GEJ adenocarcinomas. Study
of the developmental expression of mucin genes may improve understanding of the malignant transformation of esophageal tissue.
Key Words: mucin expression, gastroesophageal junction, adenocarcinoma.
The incidence of adenocarcinoma of the stomach
distal to the gastric cardia is progressively declining
in developed countries [�]. In contrast to gastric cancer�
esophageal adenocarcinoma has recently displayed
a striking increase in incidence� as reported in several
countries� including the U�A and Ukraine [���].
Recent developments in mucin histochemistry and
immunohistochemistry have made relia�le determina-
tion of the gastric and intestinal phenotypes of gastric
carcinoma cells possi�le. Phenotypic expression
changes from gastric epithelial cell type to intestinal
epithelial cell type with the growth of gastric tumors
in C�H/HeN<-->BALB/c chimeric mice treated with
N-methylN-nitrosourea [5].
The risk of adenocarcinoma developing of the
esophagus is associated with glandular metapla-
sia of multilayer epithelium� the definition of such
a morphological status is defined �y the concept
of Barrett’s esophagus �BE�. A huge num�er of works
devoted to the BE [6��] has not yet solved the pro�lem
of its diagnosis and prognosis. �o� differential diag-
nosis of BE and monitoring of these patients remain
an urgent pro�lem. One of the solutions to this pro�lem
can �e the detection of mucins expressed �y neoplas-
tic cells in adenocarcinomas.
The mucus �arrier is an important factor in the pro-
tection of the esophagus from damage during degluti-
tion and episodes of gastroesophageal reflux [9� ��].
It is now well known that tumors share several
morphological and ultra-structural features with em-
�ryonic cells [��]. The oncogerminative theory of tu-
morogenesis considers tumor formation as a dynamic
self-organizing process that mimics a self-organizing
process of early em�ryo development [��].
That’s why our purpose was to estimate and com-
pare mucins secretion in the epitheliocytes of the fetal
gastroesophageal junction �GEJ� and carcinoma cells
so as to understand �etter a �ehavior of GEJ tumors
depending on their differentiation.
MATERIALS AND METHODS
Patients. The current study was carried out
on �69 autopsied formalin-fixed human em�ryos
and fetuses of gestational age �GA� 6��� weeks
of Caucasian ethnic origin. All autopsies were
performed �etween � and �� h after death. The
presence of congenital malformations involving the
gastrointestinal tract was considered as an exclusion
criterion. Crown-rump length �CRL� was the main
criterion for estimating fetal age. The fetal ages are
indicated in Ta�le �.
Table 1. CRL of the fetus in relation to GA
№ Age, weeks Number CRL, mm
1 4–5 6 6.10 ± 0.30
2 6–7 6 15.10 ± 0.60
3 8–9 7 19.40 ± 0.50
4 10–11 10 39.02 ± 0.50
5 12–13 11 58.72 ± 2.27
6 14–15 12 93.11 ± 5.10
7 16–17 15 122.17 ± 2.70
8 18–20 19 152.90 ± 3.50
9 21–24 20 192.14 ± 1.80
10 25–28 13 230.96 ± 3.10
11 29–32 14 264.83 ± 1.70
12 33–36 20 302.92 ± 1.40
13 37–38 16 341.50 ± 5.70
Total 169 –
Exp Oncol ����
��� �� �������
Submitted: January 31, 2018.
*Correspondence: E-mail: medservervit@gmail.com
Abbreviations used: BE — Barrett’s esophagus; CCLLE — co-
lumnar cell lined lower esophagus; CRL — crown-rump length;
GA — gestational age; GEJ — gastroesophageal junction; SFE —
superficial-foveolar epithelium.
��� Experimental Oncology ��� �������� ���� ��eptem�er�
A total of 9� adult patients attending gastroenterology
services at Vinnytsia Regional Oncology Clinical Dispen-
sary from ���5 to ���� were enrolled in this comparative
study. All patients were thoroughly informed a�out the
study that was approved �y the local ethics committee.
There were 55 male �6�%� and �5 female patients
��9%�. The mean age was 5�.5� ± �.�� years �range
from �6 to 9��. The surgical specimens of GEJ adenocar-
cinomas as well as adjacent mucosa were investigated:
�� adenocarcinomas and �� signet-ring cell carcinomas�
a distri�ution of patients according to TNM staging
and degree of differentiation is given in Ta�les � and �.
There were �� resections of the esophagus for adeno-
carcinoma: �� cardiac adenocarcinomas ��6 men and
�� woman�� 5� adenocarcinomas arising in columnar cell
lined lower esophagus �CCLLE�� �9 men and �� woman.
The difference �etween cardiac and CCLLE adenocarci-
noma was determined �y the presence of columnar epi-
thelium �etween the carcinoma and either the squamous
epithelium or the cardiac line. Dysplasia was estimated
�y using the Vienna classification of gastrointestinal
epithelial neoplasia [��]. All sections were examined
�y three independent investigators.
Table 2. Distribution of patients with cancer of the GEJ according to de-
gree of differentiation
Degree of differentiation Number of cases, %
Poorly differentiated adenocarcinoma 29
Moderately differentiated adenocarcinoma 36
Well differentiated adenocarcinoma 22
Signet-ring cell carcinoma 13
Table 3. Distribution of patients with cancer of the GEJ according to TNM
staging
TNM staging Number of cases, %
ІA (T1N0M0) 10
ІB (T2N0M0) 34
ІІ (T3N0M0) 15
ІІІA (T3N1M0) 9
ІІІB (T3N2M0) 9
IV (T4N1M0) 5
IV (T4N2M0) 4
IV (T3N2M1) 3
IV (T4N2M1) 4
Histochemistry. The material consisted of �iopsy
and surgical samples. All the �iopsy samples and
surgical specimens were fixed in ��% neutral �uffered
formalin for �� h and em�edded in paraffin. �erial
sections� � μm thick� were cut from each sample� and
stained �y the following stains: haematoxylin and
eosin� AB pH �.5-PA� to differentiate acid from neutral
mucins� Gomory aldehyde fuchsin/AB pH �.5 to dif-
ferentiate sulphomucins from sialomucins �Ta�le ��.
Table 4. Histochemical techniques used to characterize mucins
Mucin type AB-PAS AF-AB
Neutral mucins Magenta 0
Sialomucins Blue Blue
Sulphomucins Blue Purple
Note: 0 — negative staining; PAS — periodic acid Schiff; AB — alcian blue;
AF — aldehyde fuchsin.
The results were expressed semiquantitatively for
each histological group as the num�er of sections
positively stained� the predominant cell type la�eled�
and the average score of the positively la�eled cells.
The extent of staining for each mucins� was scored
according to the num�er of cytoplasmic and luminal
stained carcinoma cells in ��� tumor cells. Less than
5% positive cells was accepted as negative� while
≥5% positive cells was accepted as positive [��]. The
microscopy and photographing of histological speci-
mens were performed �y using an optical microscope
OLIMPU� BX �� with magnifications of ��� ���� ��� and
���. The images were processed with standard phase
analysis; morphometry and statistical processing were
performed using the Quick PHOTO MICRO �.� pro-
gram. The content of cellular elements was determined
on the �asis of a unit of conventional area ��.�� mm��.
Statistical analysis. Results of histochemical
alterations were compared to the clinicopathologic
features using chi-square test with two tailed p value�
p < �.�5 was considered as significant.
RESULTS AND DISCUSSION
In em�ryos with CRL 6.� ± �.� mm ���5 gestation
weeks�� the epithelium of GEJ �ecomes three-layered.
Its deepest layer is formed �y columnar cells with
�asophilic cytoplasm and scant cytoplasm that con-
tains predominantly neutral mucins ��.�5 ± �.��%�
without sulfomucins and small amount of acid mucins
�Fig. �� ��.
The results of our research differ from those of other
authors whose data testify to the fact that cytochemical
changes are not typical of the given period of o�serva-
tion [��]. In our research� we noted the appearance
of �right pink and crimson granules in su�nuclear
parts of the cytoplasm of the three-layered columnar
epithelium� which was the evidence of the presence
of neutral mucins and glycogen already in this period.
The surrounding su�mucosa displayed significant
alcianophylia� which was well noticea�le while using
the com�ined PA� reaction with AB.
In em�ryos with CRL �5.� ± �.6 mm �6�� gestation
weeks�� the epithelium remains three-layered with the
presence of up to 5.�� ± �.�% of neutral mucins in the
cellular cytoplasm of the mucous mem�rane of GEJ
and small amount of sulphated mucins in the gastric
part of GEJ �Fig. ��. Already in this period� we o�-
served the appearance of single vacuoles in the cells
cytoplasm which had not �een registered �y other
authors [�5]. By the eighth week �CRL �9.� ± �.5 mm��
the epithelium remains pseudostratified. However�
already in the ninth week� the vacuoles reach their
largest volumes.
After the tenth week �CRL ����� mm�� a pseu-
dostratified epithelium starts to get considera�ly thin-
ner� and starting with CRL �� mm �ecomes ciliated
multilayered columnar. We o�served decrease of acid
mucins in the esophageal epithelium and increase
their level in gastric epithelium. �tarting with the
twelfth week� superficial-foveolar epithelium ��FE�
of the stomach cardiac region contains �oth neutral
and acid mucins with the prevailing of the latter. The
verification of mucins found out the heterogeneity
of the mucous secrete in the apical part of �FE. That
is� the internal part of the secrete got rose-pink color�
while the external one — �lue �this part contained
Experimental Oncology ��� �������� ���� ��eptem�er���� �������� ���� ��eptem�er� ��eptem�er� ��5
acid mucins�. As it can �e seen from Fig. �� in this
period the num�er of neutral mucins remains on the
same level up to sixteenth week. However� starting
with the sixteenth week� when squamous epithelium
arises in the lower part of the esophagus and colum-
nar epithelium of the stomach cardia part �ecomes
more differentiated� their num�er verita�ly increases
up to �5.9 ± �.� and ��.� ± �.�%� respectively �Fig. �� ��
and also sulfomucins appear in gastric epithelium
again. From �5 to �� gestation weeks� the progressing
decrease of acidic and sulphated mucins is o�served�
while the num�er of neutral ones increases.
During the last three months of the gestational pe-
riod� the content of acid mucins su�stantially decreases
�ut sulphated mucins do not technically occur in gas-
tric epitheliocytes� �FE and the glandular epithelium
containing mainly neutral mucins. The esophageal
epithelium during these last three months is charac-
Age, weeks
M
uc
in
s
co
nt
en
ts
, %
AM (%) NM (%) SM (%)
40
35
30
25
20
15
10
5
0
4-5 6-7 8-9 10-11 12-13 14-15 16-17 18-20 21-24 25-28 29-32 33-36 37-38
Fig. 2. Content of mucins in cardiac epitheliocytes according to the phase image analysis data �ased on �.�� mm�
Note: AM — acid mucins; NM — neutral mucins; SM — sulfomucins.
Age, weeks
M
uc
in
s
co
nt
en
ts
, %
4-5 6-7 8-9 10-11 12-13 14-15 16-17 18-20 21-24 25-28 29-32 33-36 37-38
AM (%) NM (%) SM (%)
9
8
7
6
5
4
3
2
1
0
Fig. 1. Content of mucins in esophageal epitheliocytes according to the phase image analysis data �ased on �.�� mm�
Note: AM — acid mucins; NM — neutral mucins; SM — sulfomucins.
��6 Experimental Oncology ��� �������� ���� ��eptem�er�
terized �y reduction of acid mucins with small amount
of sulfomucins and predominance of neutral mucins.
In the presence of adenocarcinomas� the intensity
of the PA� reaction decreases from marked to weak.
In this the distri�ution of secrete is predominantly granu-
lar. Poorly differentiated adenocarcinoma �G�� showed
mainly the intestinal and mixed phenotype� while 55%
of the well differentiated adenocarcinomas �G�� had
a gastric phenotype. Three of G� adenocarcinomas
were negative for all types of mucins and we applied
them to N-phenotype. Ta�le 5 shows the distri�ution
of histological diagnosis �y secretory status.
The proportion of gastric phenotype of GEJ adeno-
carcinomas is dominated �y neutral mucins in G� ad-
enocarcinomas and according to the qualitative proper-
ties corresponds to last three gestation weeks of GEJ
development� while the intestinal type includes mainly
acid mucins expression �y neoplastic cells of mod-
erately differentiated �G�� and G� ade nocarcinomas.
Mixed phenotype tumors present intermediate patterns.
The sulfomicins expression was revealed predominantly
in G� or G� adenocarcinomas and signet ring carcino-
mas. Intestinal type of adenocarcinomas was charac-
terized �y a mucin pattern similar to that which we have
o�served in the intestinal metaplasia of the stomach
[�6]. Ten of these studies included the co-expression
of the acid mucins and sulfomucins.
We have to note� however� that in the presence of the
secretion of mucins� the production of acid mucins was
revealed more often as compared to sulfomucins� which
is more characteristic for the intestinal type of cancer.
These results differ from those of some researchers [���
��]� who mainly identified sulfomucins in the mentioned
parts of the gastric mucosa. As opposed to this� all three
types of mucins� acid� neutral and sulfomucins were
found out in signet ring cell carcinomas.
Epithelial dysplasia was o�served in �� of 5� pa-
tients ��5%� with CCLLE: low-grade dysplasia was
found in 9 patients �6 men and � women� and high-
grade dysplasia in � �� men and � women�. All these
cases were found in intestinal-type epithelium� and
the association was statistically significant �p < �.�5�.
In all nine cases with low-grade epithelial dysplasia�
a loss of mucin in the cytoplasm of the go�let cells was
o�served� with a prevalence of sialomucins over sul-
phomucins. Neutral mucins were always a�sent. In the
adjacent squamous epithelium without metaplastic
and dysplastic changes the sulphomucins secretion
was poor �ut neutral mucins were most common
compared with acid ones.
The data o�tained evidence that morphological
heterogeneity is typical for �oth GEJ adenocarcinomas
and gastric ones [�9]. It is necessary to note that in dif-
ferent patients various com�inations of these types
are o�served. These data coincide with the research
of Yamamoto et al. ����5�� and our previous investiga-
tion [�6� ��] demonstrating the presence of neutral
gastric mucins in the mucous area preserved around
G� adenocarcinomas� and we suggest that the major-
ity of GEJ carcinomas retain gastric differentiation�
particularly in G� adenocarcinomas.
Based on the results of our studies� as well as data
o�tained �y other authors [��]� we can suggest a sig-
nificant clarification to the existing histological clas-
sification of the adenocarcinomas of the GEJ:
• a gastric �G� epithelial cell type �cells secretions
of which contain mainly neutral mucins and re-
vealed �y PA�-reaction�;
• an intestinal �I� epithelial cell type �cells secretions
of which contain mainly acid mucins� revealed �y AB�;
• a mixed �GI� type �cells secretions of which contain
�oth neutral and sialomucins which are distinctly
revealed in the com�ined stain AB рН �.5 — PA�-
reaction�;
• a null phenotype �N-phenotype�� neoplastic cells
with negative reaction to any of the stains �negative
in the com�ined stain AB рН �.5 — PA�-reaction�.
The data of the histochemical research ena�led
to state that G� adenocarcinomas of the gastric
type correspond to the last three months of GEJ
development� while G� and G� adenocarcinomas —
to ����5 weeks� when the transdifferentiation of the
columnar epithelium into stratified ones takes place.
The mixed type was mainly o�served in ��-week
fetuses� which corresponds to the appearance of the
alcianophylic gastric epithelium in the GEJ. However�
in the course of time� alcianophylia is lost and neutral
mucins �egin to prevail in �oth the superficial and
glandular epithelium. Our data suggest that em�ryo-
genesis and cancer share several common critical
pathways.
Thus� the results of our research showed the
decrease of the part of neutral mucins in the gastric
type of G� and G� adenocarcinomas� and their almost
complete disappearance in the case of G� adeno-
carcinoma development. Analogous changes were
o�served also in the mucosa of the GEJ surrounding
adenocarcinomas.
In contrary to adenocarcinomas� in signet ring cell
carcinomas no correspondence �etween the mucosal
qualitative changes and the gestational period was
revealed. In most cases� the mixed type of mucosa
secretions dominated� which proves the high hetero-
geneity of the given cancer form and ena�les to rec-
ommend a wider use of the com�ined PA� reaction
with AB in clinical practice.
Table 5. Content of mucins in neoplastic cells according to the phase image analysis data based on 0.01 mm2
Tumor, histological
type, (n) AM, % (n) NM, % (n) MM, % (n) SM, % (n) Negative for all
mucins, n
G1 (20) 6.71 ± 0.23 (7) 11.25 ± 0.56 (11) 4.45 ± 0.19 (2) – –
G2 (32) 3.04 ± 0. 31* (10) 6.65 ± 0.36* (15) 3.3 ± 0.18* (5) 3.5 ± 0. 3 (2) –
G3 (26) 1.56 ± 0.29* (9) 0.58 ± 0.08* (5) 2.06 ± 0.26* (8) 1.49 ± 0.21 (4) 3
Signet-ring carcinoma (12) 34.75 ± 0.25* (2) 17.5 ± 0.5* (2) 17.06 ± 0.45* (4) 6.08 ± 0.31 (4) –
Note: G1 — well differentiated adenocarcinomas; G2 — moderately differentiated adenocarcinomas; G3 — poorly differentiated adenocarcinomas; AM — acid
mucins; NM — neutral mucins; MM — mixed mucins (acid+neutral); SM — sulfomucins; — absence of mucins; *р < 0.05 compared to G1; n — number of cases.
Experimental Oncology ��� �������� ���� ��eptem�er���� �������� ���� ��eptem�er� ��eptem�er� ���
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