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Published on: January 22, 2018
Selecting Targets for Molecular Imaging of Gastric Cancer: An Immunohistochemical Evaluation
Ruben D Houvast1, Maurice van Duijvenvoorde2, Kira Thijse2
1Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands. R.D.Houvast@lumc.nl.
Purpose:
Tumor-targeted positron emission tomography (PET) and fluorescence-guided surgery (FGS) could address current challenges in pre- and intraoperative imaging of gastric cancer. Adequate selection of molecular imaging targets remains crucial for successful tumor visualization. This study evaluated the potential of integrin αvβ6, carcinoembryonic antigen-related cell adhesion molecule 5 (CEACAM5), epidermal growth factor receptor (EGFR), epithelial cell adhesion molecule (EpCAM) and human epidermal growth factor receptor-2 (HER2) for molecular imaging of primary gastric cancer, as well as lymph node and distant metastases.
Methods:
Expression of αvβ6, CEACAM5, EGFR, EpCAM and HER2 was determined using immunohistochemistry in human tissue specimens of primary gastric adenocarcinoma, healthy surrounding stomach, esophageal and duodenal tissue, tumor-positive and tumor-negative lymph nodes, and distant metastases, followed by quantification using the total immunostaining score (TIS).
Results:
Positive biomarker expression in primary gastric tumors was observed in 86% for αvβ6, 72% for CEACAM5, 77% for EGFR, 93% for EpCAM and 71% for HER2. Tumor expression of CEACAM5, EGFR and EpCAM was higher compared to healthy stomach tissue expression, while this was not the case for αvβ6 and HER2. Tumor-positive lymph nodes could be distinguished from tumor-negative lymph nodes, with accuracy ranging from 82 to 93% between biomarkers. CEACAM5, EGFR and EpCAM were abundantly expressed on distant metastases, with expression in 88-95% of tissue specimens.
Conclusion:
Our findings show that CEACAM5, EGFR and EpCAM are promising targets for molecular imaging of primary gastric cancer, as well as visualization of both lymph node and distant metastases. Further clinical evaluation of PET and FGS tracers targeting these antigens is warranted.
Insights
CEACAM5, EGFR, and EpCAM show promise as molecular imaging targets for gastric cancer, aiding in the visualization of primary tumors, lymph nodes, and distant metastases. Further clinical studies are recommended for PET and FGS applications.
Area of Science:
- Oncology
- Molecular Imaging
- Gastroenterology
Background:
- Gastric cancer imaging faces challenges in pre- and intraoperative visualization.
- Molecular imaging targets are crucial for accurate tumor detection.
Purpose of the Study:
- Evaluate integrin αvβ6, CEACAM5, EGFR, EpCAM, and HER2 as molecular imaging targets for gastric cancer.
- Assess their potential for visualizing primary tumors, lymph node, and distant metastases.
Main Methods:
- Immunohistochemistry was used to determine biomarker expression in gastric adenocarcinoma tissues.
- Expression levels were quantified using the total immunostaining score (TIS).
Main Results:
- CEACAM5, EGFR, and EpCAM showed higher expression in gastric tumors compared to healthy tissue.
- Biomarkers distinguished tumor-positive from tumor-negative lymph nodes with 82-93% accuracy.
- CEACAM5, EGFR, and EpCAM were highly expressed in distant metastases (88-95%).
Conclusions:
- CEACAM5, EGFR, and EpCAM are promising targets for gastric cancer molecular imaging.
- These biomarkers facilitate visualization of primary tumors, lymph nodes, and metastases.
- Clinical evaluation of PET and FGS tracers targeting these antigens is warranted.
