Expression of epidermal growth factor receptor, p53, Bcl2, vascular endothelial growth factor, cyclooxygenase-2, cyclin D1, human epidermal receptor-2 and Ki-67: Association with clinicopathological profiles and outcomes in gallbladder carcinoma

Dinesh Chandra Doval1, Saud Azam2, Rupal Sinha2, Ullas Batra3, Anurag Mehta4
1Department of Medical Oncology; Department of Research, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India.
2Department of Research, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India.
3Department of Medical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India.
4Laboratory Services, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India.
DOI: 10.4103/1477-3163.139450

ABSTRACT

Background: The present study observed the expression levels of epidermal growth factor receptor (EGFR), p53, Bcl2, vascular endothelial growth factor (VEGF), cyclooxygenase-2 (cox-2), cyclin D1, human epidermal receptor-2 (HER-2) and Ki-67 in gallbladder carcinoma (GBC) and their association with clinicopathological profiles and disease outcomes. Materials and Methods: Fifty consecutive samples of cholecystectomy/biopsies from GB bed (archived formalin fixed paraffin embedded tissue blocks of different stages of GBC) were included, and patient details related to their demographic profile, investigations, tumor profile, treatment, and follow-up were recorded. Immunohistochemistry was performed to study the expression levels. Results: Overexpression of EGFR, p53, Bcl2, VEGF, cox-2, cyclin D1 and HER-2 was observed as 74%, 44%, 8%, 34%, 66%, 64%, and 4%, respectively. Association of Bcl2 overexpression in mucinous morphology (40%, P = 0.045), cox-2 overexpression in early stage (I/II) tumors (87.5%, P = 0.028) and VEGF overexpression in alive patients (47.1%, P = 0.044) was observed. Co-expression of EGFR and p53 were statistically significant (P = 0.033). Ki-67 labeling index was significantly higher in patients in age group <40 years (P = 0.027), and poorly differentiated tumors (P = 0.023). Advanced disease and poorly differentiated tumors showed a significantly poor median survival (P < 0.05). Conclusion: EGFR, cox-2 and cyclin D1 were largely overexpressed. Advanced tumor stages and poorly differentiated tumors are predictors of poor survival.

Keywords: Cyclin D1, epidermal growth factor receptor, gallbladder carcinoma, human epidermal receptor-2, p53, vascular endothelial growth factor