Identification of a high-risk subtype of intestinal-type Japanese gastric cancer by quantitative measurement of the luminal tumor proportion

Toru Aoyama, Gordon Hutchins, Tomio Arai, Kentaro Sakamaki, Yohei Miyagi, Akira Tsuburaya, Takashi Ogata, Takashi Oshima, Sophie Earle, Takaki Yoshikawa*, Heike L. Grabsch*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

5 Citations (Web of Science)


Background: We hypothesized that the relative proportion of tumor (PoT) at the luminal surface can predict gastric cancer (GC) patient survival.

Methods: We measured the luminal PoT in resection specimens from 231 GC patients with stage II/III disease who had surgery at the Kanagawa Cancer Center, Yokohama, Japan. Tissue microarrays were used to assess the extent of immune cell infiltration by CD45 immunohistochemistry. Results were related to histopathological features and patient overall survival (OS).

Results: PoT was significantly lower in diffuse-type (30%) compared to intestinaltype GC (41 %) , P = 0.03. Patients with low PoT intestinal-type GC survived significantly longer than patients with high PoT intestinal-type GC (5 years OS: 78% vs 47%, P = 0.0112). Low PoT was an independent favorable prognostic factor in multivariate analysis in intestinal-type GC. Low PoT was correlated with high content of CD45-positive immune cells (P = 0.035). There was no relationship between PoT and survival in diffuse-type GC.

Conclusions: This is the first study to identify a subgroup of patients with stage II/III intestinal-type GC at high risk of recurrence by measuring PoT at the luminal surface. The relationship between PoT and immune cell content provides an initial insight into potential underlying biological mechanisms.

Original languageEnglish
Pages (from-to)4914-4923
Number of pages10
JournalCancer Medicine
Issue number10
Publication statusPublished - Oct 2018


  • gastric cancer
  • intestinal-type
  • tumor proportion

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