E-CADHERIN AND KI67 CORRELATIONS IN PATIENTS WITH LYMPH NODE METASTASES FROM GASTRIC CANCER

Aim: The aim of this study is to investigate the correlation of immunohistochemical expression of the epithelial marker E-cadherin and the proliferative marker Ki – 67 in patients with lymph node metastases from gastric carcinoma. Materials and methods: The study includes a retrospective and prospective study of 158 cases with histologically diagnosed gastric carcinoma for a period of seven years (2013-2020) from the array of the Departments of Clinical Pathology of UMHAT "Kaspela", Plovdiv and UMHAT "Pulmed", Plovdiv. All studied cases were divided into 2 groups : Intestinal type (n=97) and Diffuse type (n=61). 33 cases of patients with gastric carcinoma with lymph node metastases were selected for immunohistochemical study with E-cadherin and Ki 67. The tissue was processed with standard histopathological and immunohistochemical techniques according to standard protocols of the manufacturer using the Bond Polymer Refine Detection imaging system. Results: In the lymph node metastases group, positive linear membranous or intracytoplasmic granular E-cadherin expression was found in > 10% of tumor cells in all lymph node metastases studied, but with significant variations in intensity and percentage of positive cells between individual cases. Both in the general group and in the groups of lymph node metastases of intestinal and diffuse type of GC, the proportion of cases with reduced E-cadherin expression/positive EMT status was predominant (91%, 95% and 86%, respectively), and that of cases with preserved E-cadherin expression/negative EMT status was much smaller (9%, 5% and 14%, respectively). In the group with metastatic gastric carcinoma in the lymph nodes, all studied metastases had high proliferative activity (proliferative index > 20%). The proliferative index of metastases with intestinal type GC is significantly higher compared to the metastases with diffuse type GC. We did not find a significant relationship between the values of the proliferative index in lymph node metastases on the one hand and the individual clinico-morphological indicators. Conclusions: The proportion of tumors with reduced E-cadherin expression/positive EMP was predominant in both the general group and the groups with intestinal and diffuse type of GC, while the cases with preserved E-cadherin expression/negative EMP status were smaller. Proliferative indices in cases with advanced gastric carcinoma (pT3+T4) or lymphovascular invasion (LV+) were significantly higher compared to those with early tumor stage (pT1+T2) or without lymphovascular invasion (LV-).