Background: Using prospective follow-up studies, the authors examined the value of the expression of c-myc mRNA in biopsy specimens obtained from elevated gastric lesions as an aid in the differentiating between adenomas and well differentiated elevated-type adenocarcinomas.
Methods: By in situ hybridization, the authors determined the expression of c-myc mRNA in biopsy specimens of elevated gastric lesions. The 31 patients who had borderline lesions with and without overexpression of c-myc were followed with repeated endoscopic examinations and gastric biopsies.
Results: Endoscopic follow-up examinations showed that gastric cancer was detected in 5 of 11 patients (46%) with elevated lesions that stained positively for c-myc mRNA during an observation period of 15 months (range, 2-32 months). The cancers were confirmed histologically in gastrectomy specimens. No cancers were found in patients with elevated lesions that stained negatively. The difference was statistically significant (P < 0.01).
Conclusions: The overexpression of c-myc mRNA may present a new tool for distinguishing between adenomas and well differentiated adenocarcinomas of the elevated type.