BMI-1 expression as a marker for gallbladder cancer progression

Abstract

ObjectiveThe proto-oncogene BMI-1 is important for the survival of cancer stem cells and is implicated in the progression of various cancers, including gallbladder cancer (GBC). The trend of GBC is continuously increasing in India, and some reliable molecular markers are needed to manage this menace. We evaluated the relevance of BMI-1 expression as a prognostic biomarker in the North-Indian population and various clinicopathological features of GBC patients who visited the University hospital. MethodsWe collected the data of one-hundred patients diagnosed with GBC between October 2020 to September 2022. Out of one-hundred patients, fifty resectable tumors specimen were collected and compared with normal gall bladder tissue. Fine needle aspiration cytology (FNAC) and H&E staining are used to evaluate the biopsied tissues for various parameters. We did the immunohistochemical staining to evaluate the expression of BMI-I protein in the specimen and then performed the semiquantitative analysis. ResultsThe median age for male and female GBC cases was 55 and 52 years, respectively. It was observed that 67% (34/51) of tumor tissue showed intense positive staining as compared to 47% (24/51) of normal tissue. Moreover, BMI-I expression is significantly associated with sex, stage, and liver infiltration (p < 0.05). Analysis between variates by Mantel-Haenszel hazard ratio (HR) indicated BMI-1 expression (p = 0.04; HR=4.134; CI=1.066–16.03) as an independent molecular marker for prognosis. The COX hazard analysis for liver infiltration (p = 0.004; HR= 10.85), grade (p = 0.024; HR=0.02), and gender (p = 0.002; HR=0.01) were found to be significantly associated with worse outcomes. ConclusionOur study suggests the role of BMI-1 expression in poor prognosis of GBC in the North-Indian population and can be used as a prognostic marker. However, it needs to be tested in a large population cohort.