Expression of ERK1/2 and Bcl-2 in gastric carcinoma and their clinicopathological significance: an observational study in a tertiary care cancer hospital

Stomach cancer was ranked fifth in incidence and also fifth rank in mortality globally in 2022. It was seventh most common cancer in India. Studies have shown that ERK/MAPK pathways regulate cellular motility in both neoplastic and normal gastric epithelial cells and are involved in cell migration and invasiveness. Aberrant Bcl-2 is expressed in a sequential manner in gastric carcinogenesis. This study aims to evaluate the association between the clinicopathological features of gastric carcinoma and ERK1/2 and Bcl-2 expression in Eastern Indian Population. The study included 63 surgically resected tumour samples of patients with gastric carcinoma between 2021 and 2023. Processing of tissues was done for histopathological examination and immunohistochemistry with ERK1/2 and Bcl-2. Data was analysed and P values less than 0.05 were considered to be statistically significant. Sixty-one out of sixty-three cases of gastric carcinoma showed ERK1/2 expression on immunohistochemistry (96.8%) in the carcinoma cells. ERK1/2 expression was significantly associated with patient gender, ≥5cm tumour size, Borrmann type II tumours, Diffuse type, histological type, Grade III tumours, Lymphovascular invasion, advanced T stage, advanced N stage and a higher AJCC prognostic stage. Forty-six out of sixty-three cases of gastric carcinoma showed Bcl-2 expression (73%) in the carcinoma cells. There was a significant association of Bcl-2 expression with patient gender, ≥5cm tumour size, Borrmann type II tumours, Intestinal type, histological type of tumours, Grade II tumours, Lymphovascular invasion, advanced T stage, advanced N stage and a higher AJCC prognostic stage. Higher expressions of ERK1/2 and Bcl-2 were seen in higher tumour grade and higher AJCC prognostic stage pointing towards a prognostic significance of these markers in gastric carcinoma.