Immunohistochemical expression of -human chorionic gonadotropin in gastric carcinoma (A Clinicopathological study

number: 
1772
إنجليزية
department: 
Degree: 
Imprint: 
Medicine
Author: 
Luma Naji Abdalrezaq
Supervisor: 
Dr. Ala'a Ghani Hussain
year: 
2007

Abstract:

Carcinoma of the stomach is one of most prevalent cancer types in the world today. It is considered a major killer worldwide; therefore it remains a global health problem. Many tumor marker related to cell cycle regulation are available today, which play important role in human gastric cancer oncogenesis and progression, identifying of these markers is essential for prognostic evaluation of gastric cancer. Human Chorionic Gonadotropin is one of the notable tumor markers that produced in human cancers, including gastric cancer. The practical implications of this phenomenon in gastric cancer prognosis or early detection are under study. The aim of the study: 1. To assess the immunohistochemical expression of β-HCG in gastric carcinoma. 2. To assess the correlation between β-HCG expression and different clinicopathological variables like age, sex of patients, site, histological type, lymph node status, grade and stage of the tumor in gastric cancer. Patients, materials and methods: A retrospective study included the collection of (30) thirty formalin fixed paraffin embedded gastric carcinoma tissue blocks from the archived materials of the Center of Gastrointestinal and Hepatic Diseases, and other private laboratories, covering the period from 2000- 2007DC. Clinicopathological parameters like: age, sex of patients, site, histological type, lymph node status grade and stage of the tumor in gastric cancer were obtained from the available histopathological reports. Four micrometer-thick tissue sections were obtained, one section was stained with Hematoxylin and Eosin, while two sections were stained immunohistochemically for β-HCG. Brownish staining cytoplasm of the tumor tissue was regarded as positive β-HCG expression. Statistical analysis was performed using chi-square test for tables with frequencies, percentages, range, mean and standard error. Values were considered statistically significant when P<0.05. Results: Regarding gender distribution there was 19 male patients and 11 female patients. Male to female ratio was 1.7.The age of patients ranged between 38-78 years with a (mean ± SE) of (57.4 ± 1.2) years. Majority of the tumor 24(80%) were located in the cardia region while the remaining 6(20%) were located in the antrum. The commonest histological type was the intestinal type 16(53%).The majority 20(67%) of the gastric carcinoma cases were moderately differentiated. Most of the gastric carcinoma cases 18(60%) fall in stage III disease. The overall expression of β-HCG in gastric carcinoma cases in the present study was 12(40%). 9(75%) cases were in age group above 50 years and 3 (25%) cases in age group equal or below50 years. Cases of gastric carcinoma with positive β-HCG expression showed male predominance 7 (58.3%) compared to female 5(41.7%) cases. Most of the tumor cells with positive β-HCG immunostaining 10(83.3%) were located in the cardia region, the remaining positive β-HCG immunostaining cases 2(16.7 %) were located in the antral region. Intestinal type gastric carcinoma showed the highest β-HCG expression 10(62.5%), compared to diffuse type gastric carcinoma 2(16.7%).The majority of the cases with positive β-HCG expression 7 (41.7%) were poorly differentiated; while the remaining cases 4(33.4%) β-HCG were moderately differentiated.Most of the gastric carcinoma cases with positive β-HCG expression fall in stage III disease 11(91.7%). There was no statistically significant difference in the relationship between β-HCG expression with age, sex of patients, site, lymph node status and tumor stage (P>0.05) But there was statistically significant difference in the relationship between β-HCG expression with histological type and tumor grade. Conclusion: The overall expression of β-HCG in gastric carcinoma cases in this IHC study was 40%.There was no significant correlation between β-HCG expression and different clinicopathological variables like: age, sex of patients, site, tumor stage and lymph node status. But there was statistically significant difference in the relationship between β-HCG expression with histological type and tumor grade.