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

Abstract

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

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