Expression of p53, VEGF and E-cadherin in Gastric Carcinoma and its Association with Pathological Prognostic Factors: A Cohort Study from a Tertiary Care Hospital in Eastern India

Introduction: Gastric Carcinoma (GC) has a poor prognosis with most of the cases being detected at an advanced stage. Several potential biomarkers like p53, Vascular Endothelial Growth Factor (VEGF) and E-cadherin, have been identified for early detection and guiding the management of GC. Aim: To analyse the expression of p53, VEGF and E-cadherin in GC and to find the association of these markers with various prognostic parameters. Materials and Methods: The present cohort study was conducted over a period of 26 months. Follow-up was done for a minimum period of six months in Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India. Gastrectomy specimens, with histopathological confirmation, were included in the study, p53, VEGF and E-cadherin expression was studied along with their association with pathological prognostic parameters like histological type as per Lauren classification, histological grade and pathological stage and clinical prognostic parameters like age and gender. Statistical analysis was carried out using Microsoft Spreadsheet Excel 2010 Mini Tab/Statistical Package for Social Sciences (SPSS) version 23. Chi-square test was used and a p-value of <=0.05 was taken as statistically significant. Patient survival was calculated by Kaplan-Meier survival plot analysis. Results: In the 40 cases studied, majority were males (75%), sixth decade being the most common age group affected (Mean=56.9±11.84years). Of the three biomarkers considered, E-cadherin showed a significant association with Lauren classification (p=0.002), histologic grade (p=0.026) and nodal stage (p=0.021) of the tumour. No significant association of p53 and VEGF expression was found with various prognostic markers in the study. The median survival time for the 19 cases followed up was 40.74 months. No significant results were obtained in cumulative survival rates. Conclusion: E-cadherin can be a valuable prognostic marker in GC. Studies on larger scale and longer duration are warranted for more information on prognosis, recurrence and survival.