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Apoptosis in gastric polyps and carcinomas

We have analysed the occurrence of apoptotic cells in formalin-fixed paraffin-embedded human healthy gastric mucosa, polyps and carcinoma specimens. Histological classifications were carricd out on hematoxylin and eosin stained slides. The materials were randomly chosen from the files of the "Ljudevit Jurak" Department of Clinical Pathology, University Hospital "Sestre milosrdnice, " Zagreb. The materials werc classified into:1. healthy gastric mucosa, 2. adenomatous polyps. Gastric carcinoma specimens wcre histologically classified according to Lauren classification into 3. intestinal adenocarcinoma with mctastasis, 4. intestinal adenocarcinoma without metastasis, 5. mixed adenocarcinoma with metastasis, 6. mixed adenocarcinoma without metastasis, 7. diffuse adenocarcinoma with metastasis and 8. diffuse adenocarcinoma without metastasis. Counts of apoptotic cells were performed using the 40X objective with a calibrated eye piece Weibels' numerous-purpose M 42 stereological test system. Each group was treated stereologically determining numeric density of apoptotic cells. Using the SAS/STAT statistical soflware (SAS Institute, Cary, NC) analysis constitutes strong statistical evidence of difference between mean numeric densities of apoptotic cells in the healthy gastric mucosa, polyps and carcinomas. The results show the progressive and statistically significant increase of numeric densities from normal gastric epithelium to adenomatosus polyp and finally to cancer, which contained the greatest numbers of apoptotic cells, especially intestinal Lauren type. Duncam Multiple Range Test separated gastric cancer in three statistically different groups according to a numeric density of apoptotic cells: I. intestinal gastric cancer with metastasis (the greatest number), II. intestinal gastric cancer wiihout metastasis and diffuse gastric cancer with metastasis (medium number), III. diffuse gastric cancer without metastasis, mixed gastric cancer with and without me-tastasis (the smallest numbcr of apoptotic cells). Comparing gastric carcinoma with and without metastasis with T test we found in intestinal and diffuse adenocarcinoma statistically significant difference, P<0.01. In these two groups, carcinomas with metastasis contained greater number of apoptotic cells than without metastasis. The greatest number of apototic cells was found in intestinal adenocarcinoma with metastasis. In conclusion we confirm resutts that determined apoptosis by light microscopy examination of conventionally H&E stained slides. Our data show the progressive increase of apoptotic cells in the sequence of the healthy gastric epithelial mucosa > polyp > advanced adenocarcinoma supports thc vicw that apoptotic activity is strongly associated with gastric carcinogenesis. Apoptotic activity is specifically associated with promotion of intestinaltype gastric adenocarcinoma with metastasis.

apoptosis; gastric polyps; carcinomas

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