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| Year:
2026 |
Month:
July
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Volume:
15 |
Issue:
3 |
Page:
PO12 - PO17 |
Prognostic Significance of Bcl-2 and Ki-67 Expression in Gastric Carcinoma:
A Cross-sectional Study at a Tertiary Care Centre in Chennai, Tamil Nadu, India
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Correspondence
S Malliga, J Karthik, S Balaji,
Dr. J Karthik,
Assistant Professor, Department of Pathology, Sri Venkateshwaraa Medical College
Hospital and Research Centre, Pondicherry University, Puducherry-605102, India.
E-mail: drkarthikjms@gmail.com :
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Introduction: Gastric cancer was at fifth place in both incidence and mortality worldwide in 2022. The B-cell lymphoma (Bcl-2) anti-apoptotic gene is aberrantly expressed in a sequential manner in the carcinogenesis of gastric cancer. Ki-67 is correlated well with poorer survival and high level of expression seen in the advanced stage of gastric cancer. Biological heterogeneity and variable prognosis seen in gastric cancer are not fully explained by conventional histopathological parameters. So, the routine evaluation of Bcl-2 and Ki-67 could be helpful in identifying more aggressive disease and contribute to a better therapeutic approach.
Aim: To evaluate the Immunohistochemical (IHC) expression of Bcl-2 and Ki-67 and analyse their association with clinicopathological parameters including patient’s age, gender, tumour size, tumour site, gross, Lauren’s classification, World Health Organisation (WHO) histological subtypes, depth of invasion, grade, lymph node metastasis and Tumour-Node-Metastasis (TNM) staging system in gastric adenocarcinoma cases.
Materials and Methods: This cross-sectional study was conducted at the Department of Pathology, Government Kilpauk Medical College, Chennai, Tamil Nadu, India, over a period of 24 months, from April 2019 to March 2021. It included 50 surgically resected gastric adenocarcinoma cases. Histopathological evaluation and IHC staining for Bcl-2 and Ki-67 were performed. Data collected were entered in MS Excel and analysed using Statistical Package for the Social Sciences (SPSS) version 20.0. Associations between marker expression and clinicopathological parameters like patient age, gender, tumour size, tumour site, gross appearance, Lauren’s classification and WHO histological subtypes, other prognostic factors were analysed using Chi-square test, and Independent sample t-test, with p-value <0.05 considered statistically significant.
Results: In the present study, the age group showing peak incidence of gastric carcinoma was 51 to 60 years with a mean age of 59.7 years. Bcl-2 positivity was observed in 29 cases (58%) and showed significant association with higher tumour grade (p=0.031) and tumour stage (p=0.019). High Ki-67 Labelling Index (LI) (≥20%) was seen in 30 cases (60%) and was significantly associated with female gender (p=0.002), tumour grade (p<0.001), depth of invasion (p=0.040), lymph node metastasis (p=0.049), and tumour stage (p=0.013). The mean Ki-67 LI was significantly higher in Bcl-2-positive tumours (p=0.014).
Conclusion: Present study documented higher expression of Bcl-2 and high Ki-67 LI in advanced tumour grade and higher American Joint Committee on Cancer (AJCC) prognostic stage which may suggest a potential association with tumour aggressiveness. Bcl-2 and Ki-67 were found to be helpful in prognosis, management, and for development of newer targeted therapy.
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