Prognosis after radical esophagectomy for adenocarcinoma of the esophagus according to Laurén classification and c-erbB-2 oncogene overexpression

The aim of this study was to investigate the prognostic significance of the Laurén classification and c-erbB-2 oncogene overexpression in adenocarcinoma of the esophagus and/or gastro-esophageal junction (GEJ). Forty-one adenocarcinomas of the esophagus and/or GEJ were reviewed for tumor stage, Laurén classification, and c-erbB-2 by immunohistochemistry. According to the Laurén classification, tumors were classified as intestinal, mixed, or diffuse in 54%, 32%, and 15%, respectively. Diffuse tumors had a significantly worse prognosis than intestinal tumors. The prognostic value of the Laurén classification was independent of stage. C-erbB-2 overexpression was detected in 24% of the tumors and was present exclusively in intestinal tumors and in intestinal-type areas of mixed tumors. Ten of the 30 stage III/IV tumors were c-erbB-2 positive, while none of the 11 stage I/II tumors overexpressed the oncogene product.



Conclusions:

1) the Laurén classification is independent prognostic factor in adenocarcinoma of the esophagus and GEJ,

2) intestinal and diffuse tumors differ oncogenetically,

3) c-erbB-2 overexpression is associated with stage of disease.