Journal de gastroentérologie clinique

Histomorphological Study of Gastric Carcinoma and Correlation with P53 Immunohistochemistry

Abstract

Raga Priya and Mary Lilly

Aim: To evaluate the association and prognostic significance of P53 in gastric neoplasms with tumor site and its macroscopic appearance.
Methods: A total of 48 cases of endoscopic gastric biopsies and surgically resected specimens that include both pre-malignant and malignant neoplasms were collected. The following inclusion and exclusion criteria were adopted
Inclusion criteria: All gastric adenocarcinoma cases reported in both endoscopic biopsies as well as resected specimens, irrespective of age and sex were included for the study. Exclusion Criteria: Non-neoplastic lesions and benign tumors of stomach, Malignancies other than adenocarcinoma and gastrostomies performed for reasons other than gastric tumors were excluded from the study.
Results: GCs had a peak incidence in the age group of 51-60 years. The youngest age of presentation of gastric cancer was at 37 years in this study. 30 (62%) cases were reported in males and 18 (38%) cases were reported in females with male: female ratio accounting to 1.6:1. 25(52.08%) cases involved the pyloro-antrum, 12 (25%) involved body, 5 (10.42%) involved eso-cardia, 3 (6.25%) cases involved fundus and 3(6.25%) cases involved pan-gastric region. Ulcero-proliferative type(35%) was the most common gross appearance followed by ulcerative type(29%). P53 positivity was observed in 84% of tumors in pyloro-antrum, 83.2% of tumors in body, 40% of tumors in eso – cardia. 33.1% of tumors in fundus and 66.7% in pan – gastric tumors. The association with respect to site was found to be statistically significant with increased expression seen in tumors of pyloro-antrum. Among various gross types, P53 positivity was noted in 8 cases (57.8%) of ulcerative type, 9 cases (75%) of nodular type, 15 cases (88.2%) of ulcero-proliferative type and 3 cases (60%) of proliferative type. P53 expression showed statistically significant association with tumor location but not with macroscopic appearance. Conclusion: Identifying expression of P53 in GC could be helpful in categorizing patients eligible for targeted therapy. Patients at high risk of recurrence and poor survival can also be identified. A larger sample size and follow-up of these patients for 5 more years could throw more light on role of P53 mutation as long-term prognostic indicator.