Invasive micropapillary carcinoma: A distinct type of adenocarcinomas in the gastrointestinal tract

Table 1 Profile of invasive micropapillary carcinomas in gastrointestinal tract

Immunohistochemical marker	Invasive micropapillary carcinoma	Conventional carcinoma	Ref.
EMA	Outer membranous	Luminal	[10,13,15,19,26,29]
MUC-1	Outer membranous	Luminal	[10,12,19,25,29,30]
CD10	Stroma-facing surface	Membranous	[16,31]
Vilin	Stroma-facing surface	Membranous	[16]
E-catherin	Cytoplasmic	Membranous	[13,25,33,41]
β-catenin	Nulcear/cytoplasmic less frequent	Nulcear/cytoplasmic more frequent	[41]
		Lymphvascular epithelial cells
D2-40	Negative	Positive	[12,13,15,19,21,22]
CD34	Negative	Positive	[16,21]
CD11	Negative	Positive	[16]

Table 2 Characteristics of individual cases of colorectal invasive micropapillary carcinoma

Parameter	Sakamoto et al[19], 2005	Kuroda et al[18], 2007	Kondo et al[15], 2008	Wen et al[16], 2008	Hisanori et al[13], 2009	Sonoo et al[12], 2009	Otsubo et al[30], 2011
Age/ Sex	67/M	70/F	70/M	72/F	71/F	64/M	26/F
	68/F
	53/F
Location
Colon	3	1	1	1	1	1	1
Rectum	0	0	0	0	0	0	0
Unspecified	0	0	0	0	0	0	0
Tumor size
< 5 cm		1	1	1	1	1	1
> 5 cm		0	0	0	0	0	0
Percentage of IMPC	PD	40%	5%	PD	PD	80%	ND
Adenocarcinoma type
Nonmucinous	2	1	1	1	1	1	1
Mucinous	1	0	0	0	0	0	0
Grade of malignancy (G)	G3-2	ND	G1	ND	ND	G2	G4
	G4-1
pT stage (T)	T3-3	T3	T1	T3	T1	T1	T3
Lymphovascular invasion (Yes/No)	Yes-2	Yes	Yes	ND	Yes	Yes	Yes
	No-1
Lymph node metastasis (N) (Yes/No)	Yes-3	Yes	No	Yes	Yes	Yes	Yes
Distant metastasis (M) (Yes/No)	No	No	No	No	Yes	No	Yes

PD: Predominant; ND: No data; M: Male; F: Female.

Table 3 Characteristics of study group diagnosed with colorectal invasive micropapillary carcinoma

Parameter	Kim et al[20], 2006	Haupt et al[32], 2007	Xu et al[44], 2009	Verdú et al[10], 2011	Lino-Silva et al[42], 2012
No. of patients	55	34	30	60	15
Mean age, yr	64	66	57	65.8	56
Sex	F-15	F-15	F-13	F- 23	F-8
	M-40	M-19	M-17	M-37	M-7
Location
Colon	33	30	12	24	15
Rectum	22	2	18	36	0
Unspecified	0	2	0	0	0
Percentage of IMPC	5%-80%	5%-60%	5%-75%	5%-30%	10%-80%
Adenocarcinoma type
Nonmucinous	55	29	29	57	15
Mucinous	0	5	1	3	0
Grade of malignancy (G)
G1	5	1	13	23	0
G2	43	26	0	30	0
G3	7	7	0	7	6
G4	0	0	17	0	9
pT stage (T)
T1	2	3	0	3	0
T2	4	5	5	9	0
T3	45	24	25	38	9
T4	4	2	0	10	6
Lymphovascular invasion	Yes-25	Yes-14	Yes-10	Yes-28	Yes-5
(LV) (Yes/No)	No-30	No-20	No-20	No- 32	No-10
Lymph node metastasis (N)	Yes-41	Yes-25	Yes-19	Yes- 38	Yes-15
(Yes/No)	No-14	No-9	No-11	No-12	No-0
Distant metastasis (M)	Yes-13	Yes-4	Yes- 1	Yes-10	Yes-3
(Yes/No)	No-42	No-30	No-29	No-50	No-12
Correlations	N, M, TNM stage	N	G, N, TB	T, TNM stage, N,M, VI, PI	G, N, TNM stage

PD: Predominant; ND: No data; M: Male; F: Female; VI: Venous vessel invasion: PI: Perineural invasion.

Table 4 Invasive micropapillary carcinoma of the stomach

Parameter	Shimoda et al[17], 2008	Roh et al[31], 2010	Eom et al[40], 2011	Ushiku et al[21], 2011	Fujita et al[22], 2012	Ninomiya et al[46], 2013	Ohtsuki et al[33], 2013
No. of patients	1	11	72	17	14	1	4
Mean age, yr	74	66	70	67	62	69	69-79
Sex	M	F-3	F-18	F-3	F-4	M	F-2
		M-8	M-54	M-14	M-10		M-2
Location
Upper-third	0	1	8	6	3	1	2
Middle	1	2	20	6	7	0	1
Lower-third	0	8	44	5	4	0	0
Tumor size
< 5 cm	1	5	40	17	14	1	2
> 5 cm	0	6	32	0	0	0	3
Percentage of IMPC	PD	5%-70%	5%-80%	10%-90%	> 10%	PD	ND
Adenocarcinoma type
Tubular	Absent	Both	21	16	9	ND	2
Papillary		9/11	43	12	4		2-mixed
Grade of malignacies (G)
G1	0	ND	11	ND	6	ND	ND
G2	0	2/11	38		7
G3	1	ND	23		1
G4	0	ND	0		0
pT stage (T)
T1	0	3	20	2	0	0	0
T2	0	4	52	8	6	0	1
T3	1	2		5	8	1	2
T4	0	2		2	0	0	4
Lympho-vascular invasion (LV) (Yes/No)	Yes	Yes-10	Yes-56	Yes-17	Yes11	Yes	Yes-1
		No-1	No-16	No-0	No-3		No-3
Lymph node metastasis (N) (Yes/No)	Yes	Yes- 4	Yes-62	Yes-14	Yes	Yes	Yes-3
		No-7	No-10	No-3			No-1
Distant metastasis (M) (Yes/No)	No	ND	ND	ND	No	No	ND

PD: Predominant; ND: No data: M: Male; F: Female.

Table 5 Histopathological analysis of invasive micropapillary carcinoma in other sites of the gastrointestinal tract

Parameter	Khayyata et al[25], 2005	Kitagawa et al[26], 2007	Kondo et al[23], 2009	Fujita et al[24], 2010
No. of patients	16	1	1	1
Mean age, yr	69	67	75	53
Sex	F-6	M	F	M
	M-10
Location	Ampullo-pancreatobiliary region	Pancreatic head	Bile duct	Ampulla of Vater
Tumor size
< 5 cm	14	1	1	1
> 5 cm	ND	0	0	0
Percentage of IMPC	> 20%	PD	ND	PD
pT stage (T)
T1	0	1	0	1
T2	0	0	1	0
T3	0	0	0	0
T4	13	0	0	0
Lymphovascular invasion	Yes-3	Yes	Yes	Yes
(Yes/No)	No-13
Lymph node metastasis (N)	Yes-11	Yes	Yes	Yes
(Yes/No)	No-4
Distant metastasis (M)	Yes-4	Yes	ND	Yes
(Yes/No)	No-12

PD: Predominant; ND: No data; M: Male; F: Female.

Table 6 Immunohistochemical identification of the primary site of invasive micropapillary carcinoma

Protein/marker	Colon and rectum	Stomach	Pancreas1	Breast	Bladder	Ovary	Lung	Salivary glands
CK20	+	-	-	+	+	+	+	+
CK7	-	+	+	-	+	-	-	-
TTF-1	-	-	ND	-	-	-	+	ND
SP-A	-	-	ND	-	-	-	+	ND
ER	-	+/-	ND	+/-	-	+/-	-	-
PgR	-	-	ND	+/-	-	+/-	-	-
CA 125	+/-	ND	ND	-	+	+	ND	ND
CA 19-9	ND	ND	+	ND	ND	ND	ND	ND
CEA	+	ND	-	ND	ND	ND	ND	ND

¹And other sites in gastrointestinal tract. ND: No data.