PhD Scientific Days 2026

Poster Session 1.D - Pathological and Oncological Sciences

Morphological Discordance Between Primary Gastric Adenocarcinomas and Their Lymph Node Metastases

Előadó neve

Dr. Kocsmár, Éva, PhD

Előadó munkahelye

Semmelweis University, Department of Pathology, Forensic and Insurance Medicine

Előadó telefonszáma

+36305819025

Előadó e-mail címe

evakocsmar9@gmail.com

Az előadás címe

Morphological Discordance Between Primary Gastric Adenocarcinomas and Their Lymph Node Metastases

Szerző(k) neve és munkahelye

Éva Kocsmár¹, Bettina Zengő¹, Ildikó Kocsmár², Tibor Várkonyi¹, Attila Szijártó³, Tamás Vass³, András Kiss¹, Gábor Lotz¹

1: Department of Pathology, Forensic and Insurance Medicine, Semmelweis University
2: Department of Urology, Semmelweis University
3: Department of Surgery, Transplantation and Gastroenterology, Semmelweis University

Bemutatás módja

Poszter

Szekció

Poster Session 1.D - Pathological and Oncological Sciences

Language of the presentation

Hungarian

Preferred session

Pathological and Oncological Sciences

Összefoglaló szövege

Introduction
Histological classification of gastric adenocarcinoma (GAC) is based on the dominant morphological pattern of the primary tumor. Despite the intrinsic morphological heterogeneity of GAC, the dominant phenotype is often considered the guiding factor in the management of metastatic disease.
Aims
To assess morphological discordance between primary GACs and their lymph node metastases (LNMs), determine whether lymphatic spread induces changes in the histological pattern of LNMs, and assess the relationship between primary tumor and nodal phenotype, and adhesion marker expression.
Methods
A total of 91 pN1+ GACs were analyzed; all primary tumors contained at least focal diffuse components. Dominant morphology in primary tumors and LNMs was classified as diffuse or structured (glandular/solid). Morphological discordance was defined as non matching dominant phenotypes. E cadherin and P cadherin expression was assessed immunohistochemically in each histological component.
Results
Morphological discordance was observed in 43 of 91 cases (47%). Among discordant cases, shifts were biased toward structured nodal phenotype (36/43, 84%; p<0.001). Structured nodal morphology was more frequent in tumors with structured dominant primary phenotype (19/26) than in diffuse dominant primary tumors (31/65) (p=0.036). In multivariable analysis, both dominant primary phenotype (p=0.002) and the presence of morphological shift (p<0.001) remained independently associated with nodal phenotype. Neither E cadherin nor P cadherin expression showed an association with nodal morphology or primary-metastasis discordance.
Conclusion
GACs frequently undergo non random, directionally biased morphological changes during lymphatic dissemination. Dominant nodal morphology cannot be reliably inferred from primary tumor architecture or adhesion marker expression. Our data support that LNMs represent biologically distinct tumor manifestations, with important implications for lymph node staging and clinical management of GAC.
Funding
The study was funded by the K_22 142604 grant of the National Research, Development and
Innovation Office (Hungary), as well as supported by the 2025-2.1.1-EKÖP-2025-00014 University
Research Scholarship Programme (grant number EKÖP-2025-401) of the Ministry for Culture and
Innovation from the source of the National Research, Development and Innovation Fund.

University

Semmelweis University

Supervisor

-

Publication of my abstract

I do not give consent to the publication of my abstract on the website of the congress.

phd.section.field

after finishing doctoral studies with absolutorium (PhD)

Kind

Szabad

Status

elfogadva

Accepted presentation method

poszter

Előadás fájl jóváhagyás

nem rendelkezett róla

Előadó

2223

Start

16:54

End

16:57