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Labinvest201321.Pdf 190A ANNUAL MEETING ABSTRACTS Sensitivity, specificity, positive/negative predictive value, and the odds ratio of the SCC (0/33) by FISH. No difference of overall survival time was observed between 2 markers were summarized in Table 1. There was no difference in p16 expression amplified and non-amplified groups in EAC patients. between the DG and control group. Conclusions: ALK amplification was present in 7% of EAC cases, but ALK Table 1. Summary of sensitivity, specificity, PPV, NPV, and OR. rearrangement and expression was not present. No ALK amplification, rearrangement Sensitivity (%) Specificity (%) PPV (%) NPV (%) OR and expression were detected in SCC. ALK amplification is not associated with EAC beta-catenin 92.3 76.9 80.0 90.9 40.0 patients’ overall survival. c-met 69.2 61.5 64.3 66.7 3.6 Either 100.0 53.8 68.4 100.0 13.9* Both 61.5 92.3 88.9 70.6 19.2 785 Mitosis-Specific Marker PHH3 Immunostain Is a More Sensitive NPV, negative predictive value; PPV, positive predictive value; OR, odds ratio. *, estimated OR. and Efficient Method To Evaluate the Mitotic Activity in Gastrointestinal Conclusions: The combination of c-met and beta-catenin provides a relatively specific Stromal Tumor (GIST) panel to identify patients with BE who are at increased risk for future development S Zhu, F Lin, ZE Chen. Geisinger Medical Center, Danville, PA. of dysplasia. Background: Mitotic activity is an important prognostic factor in GIST. The accurate identification of mitotic figures on the H&E stained slides could be challenging due to 783 Microfibrillar Associated Protein 5 (MFAP 5): A Marker for processing artifact, degeneration, apoptosis, or lymphocytic infiltration. Mitosis-specific Desmoplasia That Facilitates the Distinction between an Invasive marker PHH3 was proven as a sensitive and reliable method to assess the mitotic activity Component and Pseudoinvasion in Colonic Adenomas in various tumors. The aim of the current study was to compare the PHH3-stained mitotic L Zhao, T Antic, S-Y Xiao, C VanSlambrouck, J Hart. University of Chicago, Chicago, IL. counts and the time for counting on immunostained slides with the mitotic counts and & Background: Distinction between invasive adenocarcinoma and submucosal the time for counting on H E stained slides in GIST. & displacement of adenomatous mucosa in colonic polyps can be problematic in clinical Design: Immunohistochemical stain for PHH3 and routine H E staining were practice. Recent microarray studies have demonstrated that tumor stroma exhibits performed on 45 cases (41 non-malignant and 4 malignant at the time of sampling) of & reproducible gene-expression changes compared to normal stromal tissue. MFAP5, a 25- GIST. The mitotic counts were assessed on both immunostaining slides and H E stained kD glycoprotein that is involved in elastic microfibril assembly, has been demonstrated slides. The PHH3-stained mitotic counts were compared to the mitotic counts on the & to be significantly down regulated in tumorous stroma [Jia et al. Cancer Res 2011]. H E stained slides. The time to count the mitosis by two methods was recorded too. & The aim of this study is to confirm the reduced expression of MFAP5 in tumor stroma Results: For 41 non-malignant GIST cases, the mean mitotic count on the H E by immunohistochemistry and evaluate the utility of MFAP5 as a diagnostic marker. stained slides was 1.9 per 50 high power fields and the mean PHH-stained mitotic Design: An immunohistochemical stain for MFAP 5 (Sigma) was first performed on count was 4.9 (p < 0.001) per 50 high power fields. For 4 malignant GIST cases, the & ten invasive colon cancer resection specimens to compare the its expression pattern in mean mitotic count on the H E stained slides was 47.5 per 50 high power fields and invasive tumor and in the surrounding lamina propria and submucosa. Then a total of the mean PHH-stained mitotic count was 90 per 50 high power fields. The mean time & 24 diagnostically challenging adenomatous polypectomy specimens (6 with an invasive to count the mitotic figures for 50 high power fields on the H E stained slides was 2 focus and 18 with pseudoinvasion) were used to evaluate the diagnostic value of MFAP5. minutes and 50 seconds. The mean time to count the PHH3-stained mitotic figures for Results: In all 10 colon cancer resection cases there was no reactivity in the 50 high power fields was 40 seconds (p < 0.001). desmoplastic stroma surrounding the invasive component, while the uninvolved Conclusions: PHH3 immunostain is a more sensitive and efficient method to evaluate lamina propria and submucosa exhibited strong diffuse reactivity in stromal cells. the mitotic activity in GIST. The malignant GISTs demonstrate significant higher mitotic counts by both PHH3 immunostain and H&E stained slides. 786 Etiology and Histomorphology of Esophagogastric Junction Intramucosal Adenocarcinoma (IMC): In Comparison to Esophageal IMC H Zhu, Z Li, H Xie, TW Rice, LA Rybicki, JR Goldblum, X Liu. Cleveland Clinic Foundation, Cleveland, OH; Second Military Medical University, Shanghai, China. Background: While it is clear Barrett Esophagus (BE) predisposes to esophageal adenocarcinoma, controversy exists regarding the etiology of esophagogastric junction (EGJ) adenocarcinoma. The aim of this study is to evaluate the clinical and pathologic features of EGJ IMC and compare them to IMC of the distal esophagus, as these tumors are smaller than more deeply invasive ones and allow for a better comparison of the In 16 out of 18 polypectomy specimens with pseudoinvasion, strong reactivity was surrounding mucosal changes which are often obscured by larger tumors. preserved in the stroma surrounding the displaced adenomatous mucosa (left panel of Design: 149 cases of IMC from an esophagectomy database (1983 – 2010) were figure below). Lack of staining in the stroma surrounding small foci of invasive tumor identified by reviewing medical charts and slides from these resection specimens. was observed in all 6 malignant polyps (right panel of figure below). Clinicopathologic features were compared between IMC arising in the esophagus versus EGJ. Results: Of these 149 cases; 54 cases (36.2%) were EGJ and 95 (63.7%) were esophageal IMC. Mean age and gender were not significantly different between these two groups [(61.8 yrs vs. 64.7, p=0.12; 92.6% male vs. 83.2%, p=0.14)]. Hiatal hernia was present in 87.5% and 90.5% of EGJ and esophageal IMC (p=0.51); hiatal hernia length was shorter in patients with EGJ IMC [median: 3 cm vs. 4 cm, p = 0.007)]. Compared with esophageal IMC, intestinal metaplasia (IM) in the esophagus was absent in 8 of 54 EGJ IMC (14.8% vs. 0%, p<0.001) and lack of dysplasia in IM of the esophagus was noted in patients with EGJ IMC (18.8% vs. 4.2%, p=0.012). Tumor histomorphologic features including macroscopic abnormalities, focality, size, depth of invasion, grade, Conclusions: MFAP5 is a useful marker to demonstrate tumor associated desmoplastic and lymphovascular invasion were similar. Both EGJ and esophageal IMC had low rates stromal proliferation. It facilitates the distinction between pseudoinvasion and true of nodal metastasis (0% and 1.1%). Of the 8 EGJ IMC patients without esophageal IM, invasive cancer in colonic adenomatous polyps with high sensitivity and specificity. 3 had long-standing GERD, 3 had cardia/EGJ IM associated with chronic gastritis (2) and reflux (1), 1 had a clinical history of familial adenomatous polyposis (FAP), and 1 had no apparent gastric or esophageal diseases. 784 ALK Status in Esophageal Adenocarcinoma and Squamous Conclusions: Similar to esophageal IMC, most EGJ IMC arise in patients with reflux Carcinoma Studied by DNA Microarray, FISH and Immunohistochemistry disease and intestinal metaplasia with hiatal hernia, but hiatal hernias were shorter Z Zhou, S Bandla, J Ye, L Li, T Godfrey, N Wang. University of Rochester Medical compared with esophageal IMC patients. About 7.5% EGJ IMC occurred in patients Center, Rochester, NY. without GERD and may be associated with H. pylori infection or genetic predilection. Background: The anaplastic lymphoma kinase (ALK) gene encodes a tyrosine kinase Our study supports the current view that EGJ and esophageal IMC in the USA share receptor that belongs to the insulin receptor superfamily. The 3’-tyrosine kinase domain similar etiology, tumor morphology and clinical behavior. is fused to a variety of partners such as NPM-ALK or EML4-ALK leading to express fusion proteins that play oncogenic roles in a variety of malignancies. Using mass spectroscopy alone, TPM4-ALK fusion protein was detected in esophageal squamous cell carcinoma (SCC). To verify the possible role of ALK in SCC and esophageal Genitourinary adenocarcinoma (EAC), we use different approaches to study ALK gene arrangement, amplification or expression. 787 “More Cocktails, More Cancer”; Do Pathologists Who Use Design: Genomic DNA from 116 EAC (95 M and 21 F) fresh tissue was analyzed Immunohistochemistry More Frequently on Prostate Biopsies, Diagnose for copy number aberrations using Affymetrix SNP 6.0 arrays. Tissue microarrays Prostate Cancer More Frequently? constructed at the University of Rochester between 1997 and 2005 included squamous S Al Diffalha, W Roquiz, GA Barkan, EM Wojcik, MM Picken, SE Pambuccian. Loyola mucosa (SE), EAC and SCC. ALK amplification and rearrangement were detected by University Chicago, Maywood, IL. FISH and ALK expression was tested by immunohistochemistry (IHC). Background: Atypical small acinar proliferations (ASAP), found in 1.5-5% of all Results: By genomic analysis, ALK amplification was found in 7% (8/116) EAC frozen prostate biopsies, are very small foci of atypical glands (usually <10 glands and <0.5 mm), tissue cases by SNP analysis which was confirmed by FISH test in TMA cases (7%; which show no definite histologic features of malignancy and cannot be reproducibly 5/74).
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