Expression of E-Cadherin and H.pylori in Sudanese patients with gastric adenocarcinoma and gastrointestinal stromal tumors.

Abstract

المستخلص المقدمة: هنالك دور لبروتين الايكادرين و للملوية البوابية (جرثومة المعدة) فى سرطان المعدة و السرطان المعدى- المعوى الاسترومى و تطورهما. هدفت هذه الدراسة لايجاد رابط بين هذين السرطانين و الايكادرين و الملوية البوابية و اختبارهما كواصمات حيوية فى مجموعة من العينات السودانية المشخصة باى من سرطان المعدة أو السرطان المعدى- المعوى الاسترومى. Abstract. Introduction: E-cadherin (epithelial-cadherin), is a trans-membrane glycoprotein and is down regulated in gastric cancer. H. pylori (Helicobacter pylori) infection is associated with down-regulation of E-cadherin at the early stage of gastric cancer development. Testing E-cadherin and H.pylori expression can provide potential clinical applications for diagnosis, prognosis, and therapeutic targets in gastric cancer. The role of Ecadherins and H.pylori in the progression of gastric cancer and gastrointestinal stromal carcinoma has never been studied in Sudanese samples before. This study aimed to assess the effect of H. pylori infection and E-cadherin expression and their coexpression in gastric mucosa. Materials and Methods: Fifty consecutive paraffin tissue blocks from patients diagnosed with gastric cancer (GCs) and gastrointestinal stromal carcinomas GISTs were enrolled to assess E-cadherin and H.pylori expression using immunohistochemistry biomarkers. The patients median age was 60 and mean age was 55.08. P-value was calculated using Chi- squire test (P value <0.05 is significant). Results: There was 33 (66%) samples from males and 17 (34%) from females. Thirty five (71%) were diagnosed with adenocarcinoma of gastrointestinal tract (GCs) and 15 (29%) were Gastro Intestinal Stromal Tumor (GISTs). Out of the 50 samples; 4 (8%) were diagnosed with well differential adenocarcinoma, 18 (36%) diagnosed with moderately differential adenocarcinoma, 13 (27%) diagnosed with poorly differentiated adenocarcinoma and 15 (29%) were diagnosed with gastrointestinal stromal tumor (GISTs). Expression of H.pylori were detected in 8 (16%) of GCs while in 42 (84%) of the samples H.pylori protein were not expressed. E-cadherin, was expressed in 18 (36%) while in 32 (64%) E-cadherin was unexpressed. Histological differentiation of GCs and GISTs showed significant statistical association (P=0.02) with E-cadherin under-expression. H.pylori has significant statistical association with histological differentiation of GCs (P=0.01) especially moderately differentiated and poorly differentiated adenocarcinoma, however, H.pylori expression was not detected in GISTs and well differentiated adenocarcinoma cases. Moreover H.pylori and E-cadherin coexpression showed insignificant association (P= 0.391) with neither GCs, nor with GISTs. Discussion: Progression of gastric adenocarcinomas and GISTs is mainly dependant on under-expression of E-cadherin. H.pylori might play a role in GCs development, but it does not have a role in GISTs development. Our findings showed that E-cadherin can be used as biomarker for detection of GCs and GISTs in Sudanese patients.