A histopathological evaluation of gall bladder cancer with special reference to HER2/neu and E-cadherin in Southern part of Assam

Authors

  • Madhusmita Choudhury Department of Pathology, Silchar medical College and Hospital, Silchar, Assam, India
  • Gargi Roy Choudhury Department of Pathology, Silchar medical College and Hospital, Silchar, Assam, India
  • Monoj K. Deka Department of Pathology, Silchar medical College and Hospital, Silchar, Assam, India
  • Shah A. Sheikh Department of Pathology, Silchar medical College and Hospital, Silchar, Assam, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20211871

Keywords:

Gall bladder cancer, Her2Neu, E-cadherin

Abstract

Background/Objective: Gall bladder carcinoma (GBC) is an aggressive malignancy with high mortality and aggressive course, with palliation as the only available option. The signs and symptoms of gall bladder arcinoma are not specific and often present late. Diagnosis is, therefore, often made at advanced stage with poorer outcomes. Identifying biomarkers and cancer specific cellular targets, that will pave the way for novel therapeutic approaches and early diagnosis for gall bladder carcinoma, is urgently needed. Proto-oncogenes (HER-2) and E-Cadherin are commonly deregulated in gallbladder cancer (GBC). This study evaluates the prognostic significance of HER-2 and E-Cadherin in GBC patients in Silchar Medical College.Our main objective was to evaluate frequency of HER-2/neu overexpression in GBC and to seek its correlation, if any with conventional clinicopathological parameters and survival.

Methods: A total of 168 cases were received and evaluated for Gall Bladder cancer and control specimens were prospectively collected from 2018-2020. Immunohistochemical staining was done using monoclonal antibodies to semiquantitatively evaluate HER-2 and E-Cadherin protein expression. The criterion for HER-2 and E-Cadherin positivity was set at 10% and >5% tumor cells showing complete, membranous staining. Clinicopathological correlations were drawn with major clinical outcomes. 

Results: It was observed that out of 168 cases the male to female ratio is 1:5 with highest number of cases in the age group of 50-59 , i.e., 70 cases with 41.7%. The most common location in this study was fundus with 69% of cases (116 out 0f 168), most commonly presented as biliary colic with 56 number of cases. Grading was also done in 168 cases where most number of cases were moderately differentiated with 86 number of cases with a percentage of 51%. Expression of Her2Neu and E-Cadherin was evaluated where highest number of cases were seen with 1+ score  in the IHC expressions of both the markers with 81 and 61 number of cases respectively.

 

Conclusion: The increasing global incidence, late presentation leading to poor prognosis and lack of effective therapy make the management of gall bladderv carcinoma really challenging. Our study shows the abnormal expression of HER-2 and E-Cadherin expression in gall bladder carcinoma patients in Southern Assam and suggests that  these two markers can be used for potential tool for early detection of gall bladder carcinoma and also can be used for targeted therapy in gall bladder carcinoma.

Author Biography

Gargi Roy Choudhury, Department of Pathology, Silchar medical College and Hospital, Silchar, Assam, India

Post Graduate Trainee, Department of Pathology, Silchar medical College & Hospital, Silchar, Assam

References

Kayahara M, Nagakawa T, Nakagawara H, Kitagawa H, Ohta T. Prognostic factors for gallbladder cancer in Japan. Ann surg. 2008;248(5):807-14.

Miura F, Asano T, Amano H, Toyota N, Wada K, Kato K et al. New prognostic factor influencing long-term survival of patients with advanced gallbladder carcinoma. Surgery. 2010;148(2):271-7.

Khan ZR, Neugut AI, Ahsan H, Chabot JA. Risk factors for biliary tract cancers. Am j gastroenterol. 1999;94(1):149-52.

Yang Y, Chen Y, Ye F, Cao X, Xin Y, Wang Yet al. Late recurrence of hepatocellular carcinoma after radiofrequency ablation: a multicenter study of risk factors, patterns, and survival. Eur Radiol. 2020;11:1-2.

Garrett TP, McKern NM, Lou M, Elleman TC, Adams TE, Lovrecz GO et al. The crystal structure of a truncated ErbB2 ectodomain reveals an active conformation, poised to interact with other ErbB receptors. Molecular cell. 2003;11(2):495-505.

Graus‐Porta D, Beerli RR, Daly JM, Hynes NE. ErbB‐2, the preferred heterodimerization partner of all ErbB receptors, is a mediator of lateral signaling. EMBO j. 1997;16(7):1647-55.

Hirohashi S. Inactivation of the E-cadherin-mediated cell adhesion system in human cancers. Am j pathol. 1998;153(2):333-9.

Pais-Costa SR, Farah JF, Artigiani-Neto R, Martins SJ, Goldenberg A. Evaluation of P53, E-cadherin, Cox-2, and EGFR protein imunnoexpression on prognostic of resected gallbladder carcinoma. ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo). 2014;27(2):126-32.

Jain P, Goyal S, Chauhan G, Majumdar K, Ali S, Sakhuja P et al. HER-2/neu over expression in gall bladder adenocarcinoma: A quest for potential therapeutic target. Indian J Pathol Microbiol. 2020;63(2):214.

Konstantinidis IT, Deshpande V, Genevay M, Berger D, Fernandez-del Castillo C, Tanabe KK et al. Trends in presentation and survival for gallbladder cancer during a period of more than 4 decades: a single-institution experience. Arch surg. 2009;144(5):441-7.

Nahar K, Quddus MA, Islam KM, Islam MA. Prevalence of Gall Bladder Carcinoma in Patients with Cholelithiasis. J Surg Sci. 2012;16(2):68-70.

Duffy A, Capanu M, Abou‐Alfa GK, Huitzil D, Jarnagin W, Fong Y et al. Gallbladder cancer (GBC): 10‐year experience at memorial Sloan‐Kettering cancer centre (MSKCC). J surg oncol. 2008;98(7):485-9.

Singh A, Mishra PK, Saluja SS, Talikoti MA, Kirtani P, Najmi AK. Prognostic significance of HER-2 and p53 expression in gallbladder carcinoma in North Indian patients. Oncology. 2016;91(6):354-60.

Ashai F, Ashraf A, Rashid A, Banday BM, Bhalla S, Dhawan S. Expression of HER2/neu receptor in carcinoma gallbladder correlates significantly with advanced tumor stage. Int J Hepatobiliary Pancreat Dis. 2015;5:86-91.

Harder J, Waiz O, Otto F, Geissler M, Olschewski M, Weinhold B et al. EGFR and HER2 expression in advanced biliary tract cancer. World j gastroenterol. 2009;15(36):4511.

Xu ST, Ma YC, Wang CH, Xu Y, Gu GJ. Prognostic and clinicopathologic significance of AEG-1/MTDH and E-cadherin expression in human gallbladder carcinoma. Int j clin exp pathol. 2018;11(1S2):6025.

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Published

2021-04-28

How to Cite

Choudhury, M., Choudhury, G. R., Deka, M. K., & Sheikh, S. A. (2021). A histopathological evaluation of gall bladder cancer with special reference to HER2/neu and E-cadherin in Southern part of Assam. International Journal of Research in Medical Sciences, 9(5), 1368–1373. https://doi.org/10.18203/2320-6012.ijrms20211871

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Original Research Articles