Skip to main content

Pathology of Hereditary Gastric Cancer

  • Chapter
  • First Online:
Spotlight on Familial and Hereditary Gastric Cancer

Abstract

Hereditary gastric cancer includes the hereditary diffuse gastric cancer syndrome and a recently described syndrome designated as gastric adenocarcinoma and proximal polyposis of the stomach. Hereditary diffuse gastric cancer is caused by E-cadherin gene (CDH1) alterations and a model of development has been described, encompassing mild non-atrophic gastritis, in situ signet ring cell (diffuse) carcinoma, pagetoid spread of signet ring cells and invasive carcinoma. Gastric adenocarcinoma and proximal polyposis of the stomach is characterized by fundic gland polyposis, with areas of dysplasia or intestinal type gastric cancer, restricted to the proximal stomach, with no evidence of colorectal or duodenal polyposis or other heritable gastrointestinal cancer syndromes. The genetic cause of gastric adenocarcinoma and proximal polyposis of the stomach has not been identified yet.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

EGFR:

Epidermal Growth Factor Receptor

FAP:

Familial Adenomatous Polyposis

FDGC:

Familial Diffuse Gastric Cancer

FGC:

Familial Gastric Cancer

FGP:

Fundic Gland Polyposis

GAPPS:

Gastric Adenocarcinoma and Proximal Polyposis of the Stomach

HDGC:

Hereditary Diffuse Gastric Cancer

IGCLC:

International Gastric Cancer Linkage Consortium

MAP:

MYH-Associated Polyposis

PJS:

Peutz–Jeghers Syndrome

RTK:

Receptor Tyrosine Kinase

References

  • Avizienyte E, Frame MC (2005) Src and FAK signalling controls adhesion fate and the epithelial-to-mesenchymaltransition. Curr Opin Cell Biol 17:542–547. doi:10.1016/j.ceb.2005.08.007

    Article  PubMed  CAS  Google Scholar 

  • Barber M, Murrell A, Ito Y, Maia AT, Hyland S, Oliveira C, Save V, Carneiro F, Paterson AL, Grehan N, Dwerryhouse S, Lao-Sirieix P, Caldas C, Fitzgerald RC (2008a) Mechanisms and sequelae of E-cadherin silencing in hereditary diffuse gastric cancer. J Pathol 216:295–306. doi:10.1002/path.2426 (a)

    Article  PubMed  CAS  Google Scholar 

  • Barber ME, Save V, Carneiro F, Dwerryhouse S, Lao-Sirieix P, Hardwick RH, Caldas C, Fitzgerald RC (2008b) Histopathological and molecular analysis of gastrectomy specimens from hereditary diffuse gastric cancer patients has implications for endoscopic surveillance of individuals at risk. J Pathol 216:286–294. doi:10.1002/path.2415 (b)

    Article  PubMed  CAS  Google Scholar 

  • Blair V, Martin I, Shaw D, Winship I, Kerr D, Arnold J, Harawira P, McLeod M, Parry S, Charlton A, Findlay M, Cox B, Humar B, More H, Guilford P (2006) Hereditary diffuse gastric cancer: diagnosis and management. Clin Gastroenterol Hepatol 4(262):275. doi:10.1016/j.cgh.2005.12.003

    Google Scholar 

  • Caldas C, Carneiro F, Lynch HT, Yokota J, Wiesner GL, Powell SM, Lewis FR, Huntsman DG, Pharoah PD, Jankowski JA, MacLeod P, Vogelsang H, Keller G, Park KG, Richards FM, Maher ER, Gayther SA, Oliveira C, Grehan N, Wight D, Seruca R, Roviello F, Ponder BA, Jackson CE (1999) Familial gastric cancer: overview and guidelines for management. J Med Genet 36:873–880

    PubMed  CAS  Google Scholar 

  • Carneiro F, Huntsman DG, Smyrk TC, Owen DA, Seruca R, Pharoah P, Caldas C, Sobrinho-Simões M (2004) Model of the early development of diffuse gastric cancer in E-cadherin mutation carriers and its implications for patient screening. J Pathol 203:681–687. doi:10.1002/path.1564

    Article  PubMed  CAS  Google Scholar 

  • Carneiro F, Oliveira C, Suriano G, Seruca R (2008) Molecular pathology of familial gastric cancer, with an emphasis on hereditary diffuse gastric cancer (HDGC). J Clin Pathol 61:25–30. doi:10.1136/jcp.2006.043679

    Article  PubMed  CAS  Google Scholar 

  • Caron O, Schielke A, Svrcek M, Fléjou JF, Garzon J, Olschwang S, Sézeur A (2008) Usefulness of prophylactic gastrectomy in a novel large hereditary diffuse gastric cancer (HDGC) family. Am J Gastroenterol 103:2160–2161. doi:10.1111/j.1572 0241.2008.01982_17.x

    Article  PubMed  Google Scholar 

  • Charlton A, Blair V, Shaw D, Parry S, Guilford P, Martin IG (2004) Hereditary diffuse gastric cancer: predominance of multiple foci of signet ring cell carcinoma in distal stomach and transitional zone. Gut 53:814–820

    Article  PubMed  CAS  Google Scholar 

  • Chun YS, Lindor NM, Smyrk TC, Petersen BT, Burgart LJ, Guilford PJ, Donohue JH (2001) Germline E-cadherin gene mutations: is prophylactic total gastrectomy indicated? Cancer 92:181–187

    Article  PubMed  CAS  Google Scholar 

  • Chung DC, Yoon SS, Lauwers GY, Patel D (2007) A women with a family history of gastric and breast cancer. N Engl J Med 357:283–291

    Article  PubMed  CAS  Google Scholar 

  • Corso G, Roviello F, Paredes J, Pedrazzani C, Novais M, Correia J, Marrelli D, Cirnes L, Seruca R, Oliveira C, Suriano G (2007) Characterization of the P373L E-cadherin germline missense mutation and implication for clinical management. Eur J Surg Oncol 33:1061–1067. doi:10.1016/j.ejso.2007.03.001

    Article  PubMed  CAS  Google Scholar 

  • Crepaldi T, Pollack AL, Prat M, Zborek A, Mostov K, Comoglio PM (1994) Targeting of the SF/HGF receptor to the basolateral domain of polarized epithelial cells. J Cell Biol 125:313–320

    Article  PubMed  CAS  Google Scholar 

  • Fitzgerald RC, Hardwick R, Huntsman D, Carneiro F, Guilford P, Blair V, Chung DC, Norton J, Ragunath K, Van Krieken JH, Dwerryhouse S, Caldas C, International Gastric Cancer Linkage Consortium on behalf of the International Gastric Cancer Linkage Consortium (2010) Hereditary diffuse gastric cancer: updated consensus guidelines for clinical management and directions for future research. J Med Genet 47:436–444. doi:10.1136/jmg.2009.074237

    Article  PubMed  CAS  Google Scholar 

  • Francis WP, Rodrigues DM, Perez NE, Lonardo F, Weaver D, Webber JD (2007) Prophylactic laparoscopic-assisted total gastrectomy for hereditary diffuse gastric cancer. JSLS 11:142–147

    PubMed  Google Scholar 

  • Fujita H, Lennerz JK, Chung DC, Patel D, Deshpande V, Yoon SS, Lauwers GY (2012) Endoscopic surveillance of patients with hereditary diffuse gastric cancer: biopsy recommendations after topographic distribution of cancer foci in a series of 10 CDH1 mutated gastrectomies. Am J Surg Pathol 36(11):1709–1717. doi:10.1097/PAS.0b013e31826ca204

    Article  PubMed  Google Scholar 

  • Gaya DR, Stuart RC, Going JJ, Stanley AJ (2008) Hereditary diffuse gastric cancer associated with E-cadherin mutation: penetrance after all. Eur J Gastroenterol Hepatol 20(12):1249–1251. doi:10.1097/MEG.0b013e328303df31

    Article  PubMed  Google Scholar 

  • Gaya DR, Stuart RC, McKee RF, Going JJ, Davidson R, Stanley AJ (2005) E-cadherin mutation associated diffuse gastric adenocarcinoma: penetrance and nonpenetrance. Eur J Gastroenterol Hepatol 17:1425–1428

    Article  PubMed  Google Scholar 

  • Gayther SA, Gorringe KL, Ramus SJ, Huntsman D, Roviello F, Grehan N, Machado JC, Pinto E, Seruca R, Halling K, MacLeod P, Powell SM, Jackson CE, Ponder BA, Caldas C (1998) Identification of germline E-cadherin mutations in gastric cancer families of European origin. Cancer Res 58:4086–4089

    PubMed  CAS  Google Scholar 

  • Gionti E, Capasso O, Capasso O, Cancedda R (1983) The culture of chick embryo chondrocytes and the control of their differentiated functions in vitro. Transformation by rous sarcoma virus induces a switch in the collagen type synthesis and enhances fibronectin expression. J Biol Chem 258:7190–7194

    PubMed  CAS  Google Scholar 

  • Grady WM, Willis J, Guilford PJ, Dunbier AK, Toro TT, Lynch H, Wiesner G, Ferguson K, Eng C, Park JG, Kim SJ, Markowitz S (2000) Methylation of the CDH1 promoter as the second genetic hit in hereditary diffuse gastric cancer. Nat Genet 26(16):17. doi:10.1038/79120

    Google Scholar 

  • Guilford P, Hopkins J, Harraway J, McLeod M, McLeod N, Harawira P, Taite H, Scoular R, Miller A, Reeve AE (1998) E-cadherin germline mutations in familial gastric cancer. Nature 392:402–405. doi:10.1038/32918

    Article  PubMed  CAS  Google Scholar 

  • Guilford PJ, Hopkins JB, Grady WM, Markowitz SD, Willis J, Lynch H, Rajput A, Wiesner GL, Lindor NM, Burgart LJ, Toro TT, Lee D, Limacher JM, Shaw DW, Findlay MP, Reeve AE (1999) E-cadherin germline mutations define an inherited cancer syndrome dominated by diffuse gastric cancer. Hum Mutat 14:249–255. doi:10.1002/(SICI)1098-1004(1999)14:3<249::AID-HUMU8>3.0.CO;2–9

    Article  PubMed  CAS  Google Scholar 

  • Hackenson D, Edelman DA, McGuire T, Weaver DW, Webber JD (2010) Prophylactic laparoscopic gastrectomy for hereditary diffuse gastric cancer: a case series in a single family. JSLS 14(3):348–352. doi:10.4293/108680810X12924466007449

    Article  PubMed  Google Scholar 

  • Hebbard PC, Macmillan A, Huntsman D, Kaurah P, Carneiro F, Wen X, Kwan A, Boone D, Bursey F, Green J, Fernandez B, Fontaine D, Wirtzfeld DA (2009) Prophylactic total gastrectomy (PTG) for hereditary diffuse gastric cancer (HDGC): the Newfoundland experience with 23 patients. Ann Surg Oncol 16:1890–1895. doi:10.1245/s10434-009-0471-z

    Article  PubMed  CAS  Google Scholar 

  • Hoschuetzky H, Aberle H, Kemler R (1994) Beta-catenin mediates the interaction of the cadherin-catenin complex with epidermal growth factor receptor. J Cell Biol 127(1375):1380

    Google Scholar 

  • Humar B, Guilford P (2008) Hereditary diffuse gastric cancer and lost cell polarity: a short path to cancer. Future Oncol 4:229–239. doi:10.2217/14796694.4.2.229

    Article  PubMed  CAS  Google Scholar 

  • Humar B, Fukuzawa R, Blair V, Dunbier A, More H, Charlton A, Yang HK, Kim WH, Reeve AE, Martin I, Guilford P (2007) Destabilized adhesion in the gastric proliferative zone and c-Src kinase activation mark the development of early diffuse gastric cancer. Cancer Res 67:2480–2489. doi:10.1158/0008-5472.CAN-06-3021

    Article  PubMed  CAS  Google Scholar 

  • Huntsman DG, Carneiro F, Lewis FR, MacLeod PM, Hayashi A, Monaghan KG, Maung R, Seruca R, Jackson CE, Caldas C (2001) Early gastric cancer in young, asymptomatic carriers of germ-line E-cadherin mutations. N Engl J Med 344:1904–1909. doi:10.1056/NEJM200106213442504

    Article  PubMed  CAS  Google Scholar 

  • Kaurah P, Fitzgerald R, Dwerryhouse S, Huntsman DG (2010) Pregnancy after prophylactic total gastrectomy. Fam Cancer 9:331–334. doi:10.1007/s10689-009-9316 y

    Article  PubMed  Google Scholar 

  • Kluijt I, Siemerink EJ, Ausems MG, van Os TA, de Jong D, Simões-Correia J, van Krieken JH, Ligtenberg MJ, Figueiredo J, van Riel E, Sijmons RH, Plukker JT, van Hillegersberg R, Dekker E, Oliveira C, Cats A, Hoogerbrugge N, Dutch Working Group on Hereditary Gastric Cancer (2012) CDH1-related hereditary diffuse gastric cancer syndrome: clinical variations and implications for counseling. Int J Cancer 131(2):367–376. doi:10.1002/ijc.26398

    Article  PubMed  CAS  Google Scholar 

  • Koea JB, Karpeh MS, Brennan MF (2007) Gastric cancer in young 524 patients: demographic, clinicopathological, and prognostic 525 factors in 92 patients. Ann Surg Oncol 7:346–351

    Article  Google Scholar 

  • La Vecchia C, Negri E, Franceschi S, Gentile A (1992) Family history and the risk of stomach and colorectal cancer. Cancer 70:50–55

    Article  PubMed  Google Scholar 

  • Lewis FR, Mellinger JD, Hayashi A, Lorelli D, Monaghan KG, Carneiro F, Huntsman DG, Jackson CE, Caldas C (2001) Prophylactic total gastrectomy for familial gastric cancer. Surgery 130:612–619. doi:10.1067/msy.2001.117099

    Article  PubMed  CAS  Google Scholar 

  • Lynch HT, Kaurah P, Wirtzfeld D, Rubinstein WS, Weissman S, Lynch JF, Grady W, Wiyrick S, Senz J, Huntsman DG (2008) Hereditary diffuse gastric cancer: diagnosis, genetic counseling, and prophylactic total gastrectomy. Cancer 112:2655–2663. doi:10.1002/cncr.23501

    Article  PubMed  Google Scholar 

  • Mareel M, Leroy A (2003) Clinical, cellular, and molecular aspects of cancer invasion. Physiol Rev 83:337–376

    PubMed  CAS  Google Scholar 

  • Mateus AR, Seruca R, Machado JC, Keller G, Oliveira MJ, Suriano G, Luber B (2007) EGFR regulates RhoAGTP dependent cell motility in E-cadherin mutant cells. Hum Mol Genet 16:1639–1647. doi:10.1093/hmg/ddm113

    Article  PubMed  CAS  Google Scholar 

  • Mateus AR, Simões-Correia J, Figueiredo J, Heindl S, Alves CC, Suriano G, Luber B, Seruca R (2009) E-cadherin mutations and cell motility: a genotype-phenotype correlation. Exp Cell Res 315:1393–1402. doi:10.1016/j.yexcr.2009.02.020

    Article  PubMed  CAS  Google Scholar 

  • Newman EA, Mulholland MW (2006) Prophylactic gastrectomy for hereditary diffuse gastric cancer syndrome. J Am Coll Surg 202:612–617. doi:10.1016/j.jamcollsurg.2005.12.017

    Article  PubMed  Google Scholar 

  • Norton JA, Ham CM, Van Dam J, Jeffrey RB, Longacre TA, Huntsman DG, Chun N, Kurian AW, Ford JM (2007) CDH1 truncating mutations in the E-cadherin gene: an indication for total gastrectomy to treat hereditary diffuse gastric cancer. Ann Surg 245:873–879. doi:10.1097/01.sla.0000254370.29893.e4

    Article  PubMed  Google Scholar 

  • Oelschlager BK, Yigit T, Kaufman JA, Pellegrini CA (2005) Hereditary diffuse gastric cancer. Med Gen Med 7:16

    Google Scholar 

  • Oliveira C, Seruca R, Carneiro F (2006) Genetics, pathology, and clinics of familial gastric cancer. Int J Surg Pathol 14:21–33

    Article  PubMed  CAS  Google Scholar 

  • Oliveira C, de Bruin J, Nabais S, Ligtenberg M, Moutinho C, Nagengast FM, Seruca R, van Krieken H, Carneiro F (2004) Intragenic deletion of CDH1 as the inactivating mechanism of the wild-type allele in a HDGC tumour. Oncogene 23:2236–2240. doi:10.1038/sj.onc.1207335

    Article  PubMed  CAS  Google Scholar 

  • Oliveira C, Moreira H, Seruca R, de Oliveira MC, Carneiro F (2005) Role of pathology in the identification of hereditary diffuse gastric cancer: report of a Portuguese family. Virchows Arch 446:181–184. doi:10.1007/s00428-004-1156-4

    Article  PubMed  Google Scholar 

  • Oliveira C, Senz J, Kaurah P, Pinheiro H, Sanges R, Haegert A, Corso G, Schouten J, Fitzgerald R, Vogelsang H, Keller G, Dwerryhouse S, Grimmer D, Chin SF, Yang HK, Jackson CE, Seruca R, Roviello F, Stupka E, Caldas C, Huntsman D (2009a) Germline CDH1 deletions in hereditary diffuse gastric cancer families. Hum Mol Genet 18:1545–1555. doi:10.1093/hmg/ddp046

    Article  PubMed  CAS  Google Scholar 

  • Oliveira C, Sousa S, Pinheiro H, Karam R, Bordeira-Carriço R, Senz J, Kaurah P, Carvalho J, Pereira R, Gusmão L, Wen X, Cipriano MA, Yokota J, Carneiro F, Huntsman D, Seruca R (2009b) Quantification of epigenetic and genetic second hits in CDH1 during hereditary diffuse gastric cancer syndrome progression. Gastroenterology 136:2137–2148. doi:10.1053/j.gastro.2009.02.065

    Article  PubMed  CAS  Google Scholar 

  • Pandalai PK, Lauwers GY, Chung DC, Patel D, Yoon SS (2011) Prophylactic total gastrectomy for individuals with germline CDH1 mutation. Surgery 149(3):347–355. doi:10.1016/j.surg.2010.07.005

    Article  PubMed  Google Scholar 

  • Qian X, Karpova T, Sheppard AM, McNally J, Lowy DR (2004) E-cadherin-mediated adhesion inhibits ligand-dependent activation of diverse receptor tyrosine kinases. EMBO J 23:1739–1748. doi:10.1038/sj.emboj.7600136

    Article  PubMed  CAS  Google Scholar 

  • Richards FM, McKee SA, Rajpar MH, Cole TR, Evans DG, Jankowski JA, McKeown C, Sanders DS, Maher ER (1999) Germline E-cadherin gene (CDH1) mutations predispose to familial gastric cancer and colorectal cancer. Hum Mol Genet 8:607–610

    Article  PubMed  CAS  Google Scholar 

  • Rogers WM, Dobo E, Norton JA, Van Dam J, Jeffrey RB, Huntsman DG, Kingham K, Chun N, Ford JM, Longacre TA (2008) Risk-reducing total gastrectomy for germline mutations in E-cadherin (CDH1): pathologic findings with clinical implications. Am J Surg Pathol 32:799–809. doi:10.1097/PAS.0b013e31815e7f1a

    Article  PubMed  Google Scholar 

  • Shaw D, Blair V, Framp A, Harawira P, McLeod M, Guilford P, Parry S, Charlton A, Martin I (2005) Chromoendoscopic surveillance in hereditary diffuse gastric cancer: an alternative to prophylactic gastrectomy? Gut 54:461–468. doi:10.1136/gut.2004.049171

    Article  PubMed  CAS  Google Scholar 

  • van Kouwen MC, Drenth JP, Oyen WJ, de Bruin JH, Ligtenberg MJ, Bonenkamp JJ, van Krieken JH (2004) Nagengast FM (2004) [18F]fluoro-2-deoxy-D-glucose positron emission tomography detects gastric carcinoma in an early stage in an asymptomatic E cadherin mutation carrier. Clin Cancer Res 10:6456–6459. doi:10.1158/10780432.CCR-04-0599

    Article  PubMed  Google Scholar 

  • Varley JM, McGown G, Thorncroft M, Tricker KJ, Teare MD, Santibanez-Koref MF, Martin J, Birch JM, Evans DG (1995) An extended Li-Fraumeni kindred with gastric carcinoma and a codon 175 mutation in TP53. J Med Genet 32:942–945

    Article  PubMed  CAS  Google Scholar 

  • Vasen HF, Wijnen JT, Menko FH, Kleibeuker JH, Taal BG, Griffioen G, Nagengast FM, Meijers-Heijboer EH, Bertario L, Varesco L, Bisgaard ML, Mohr J, Fodde R, Khan PM (1996) Cancer risk in families with hereditary nonpolyposis colorectal cancer diagnosed by mutation analysis. Gastroenterology 110:1020–1027

    Article  PubMed  CAS  Google Scholar 

  • Worthley DL, Phillips KD, Wayte N, Schrader KA, Healey S, Kaurah P, Shulkes A, Grimpen F, Clouston A, Moore D, Cullen D, Ormonde D, Mounkley D, Wen X, Lindor N, Carneiro F, Huntsman DG, Chenevix-Trench G, Suthers GK (2012) Gastric adenocarcinoma and proximal polyposis of the stomach (GAPPS): a new autosomal dominant syndrome. Gut 61:774–779. doi:10.1136/gutjnl-2011-300348

    Article  PubMed  CAS  Google Scholar 

  • Yanaru-Fujisawa R, Nakamura S, Moriyama T, Esaki M, Tsuchigame T, Gushima M, Hirahashi M, Nagai E, Matsumoto T, Kitazono T (2012) Familial fundic gland polyposis with gastric cancer. Gut 61:1103–1104. doi:10.1136/gutjnl-2011-301384

    Article  PubMed  Google Scholar 

  • Yap AS, Kovacs EM (2003) Direct cadherin-activated cell signaling: a view from the plasma membrane. J Cell Biol 160:11–16. doi:10.1083/jcb.200208156

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Fátima Carneiro M.D., Ph.D. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer Science+Business Media Dordrecht

About this chapter

Cite this chapter

Carneiro, F. (2013). Pathology of Hereditary Gastric Cancer. In: Corso, G., Roviello, F. (eds) Spotlight on Familial and Hereditary Gastric Cancer. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-6570-2_12

Download citation

Publish with us

Policies and ethics