Expression of human epidermal growth factor receptor 2, survivin, enhancer of zeste homolog -2, COX-2, p53 and p16 molecular markers in gall bladder carcinoma

Abstract

Purpose: Gallbladder cancer exhibits striking variability in the global rates, reaching epidemic levels for some regions and ethnicities. The basis of its variability resides in differences in environmental exposure and intrinsic genetic predisposition to carcinogenesis. There is little information present regarding genetic and molecular alterations in gall bladder cancer. We, therefore, have evaluated the molecular marker expression in gall bladder cancer and study their correlation with clinicopathological staging. Material & methods: This prospective observational study was conducted on newly diagnosed gall bladder cancer (GBC) patients from July 2017 to July 2020. After complete staging workup and the GBC biopsy samples paraffin block were tested for molecular markers ER, PR, p53, p16, Human epidermal growth factor receptor 2 (HER 2-neu), Survivin, Enhancer of zeste homolog -2 (EZH2), and Cyclooxygenase-2 (COX-2) expression by immunohistochemistry.(table 1) Results: Fifty newly diagnosed patients of carcinoma gall bladder were included in the present study. Age ranged from 29 – 69 years (mean 53.42). p53 was the most common positive marker in 74% of patients, survivin in 58%, COX-2 in 44%, p16 in 42% whereas Her 2 neu and EZH-2 were positive in 16 % of patients each. None of the patients of GBC were ER or PR positive.Table 1: Markers and their frequency in GBC patients. There was a significant difference between the various groups in terms of the distribution of histological grade and Her 2 neu (χ2 = 9.886, p = 0.014) but not with other markers. Also, there was a significant difference in terms of distribution of p16 and p53 with stage (χ2 = 7.017, p = 0.037 and χ2 = 5.861, p = 0.033) respectively. (figure;1)MarkerFrequencyPercentageHer2/neu•Negative4284.0•3+816.0p53•Positive3774.0•Negative1326.0P16•Positive2142.0•Negative2958.0Survivin•Positive2958.0•Negative2142.0COX-2•Positive2244.0•Negative2856.0EZH-2•Positive816.0•Negative4284.0 Open table in a new tab Conclusion: The present study shows the expression of molecular markers Her2 neu, p53, p16, survivin, COX-2, and EZH-2 in GBC. It can be used in the future for the detection of disease in the early phase and targeted therapy.