Spectrum of Gastric Carcinoma in a Tertiary Care Centre with Special Reference to PDL1 and Cyciln D1
Binata Bandopadhyay
Department of Pathology, Murshidabad Medical College, Murshidabad, West Bengal, India.
Madhumita Mukhopadhyay *
Department of Pathology, IPGME&R, Kolkata, West Bengal, India and JISMSR, West Bengal, India.
Chhanda Das
Department of Pathology, NRSMCH, Kolkata, India.
Abhishek Dutta
Department of Pathology, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India.
Subhamoy Saha
Department of Pathology, IPGME&R, Kolkata, West Bengal, India.
Biswanath Mukhopadhyay
Department of Pediatric Surgery, Apollo Multispeciality Hospital, Kolkata, India.
*Author to whom correspondence should be addressed.
Abstract
Introduction: Gastric carcinoma is the fifth most frequently diagnosed tumor and the fourth leading cause of death. They represent a heterogenous group of tumors with multifactorial etiologies, both environmental and genetic. PD-L1 is a transmembrane protein, and a positive PD-L1 expression in gastric carcinoma may be a predictive biomarker of the response to PD-1/PD-L1 immune checkpoint inhibitors. Cyclin D1 is an important cell cycle regulatory protein and involved in the carcinogenesis of various cancers including gastric cancer.
Aims: The aim of this study is to find out the clinicopathological spectrum of gastric carcinoma and to show the immunohistochemical expression of Cyclin D1 and PD-L1 to evaluate their prognostic importance and their therapeutic impact.
Study Design: It is an observational cross-sectional study conducted in the Department of Pathology in collaboration with the Department of Surgery, in a tertiary care hospital. Partial and total gastrectomies were selected from January 2021 to July 2022 in a tertiary care hospital. Clinical history was collected in the study proforma. Immunohistochemical staining for Cyclin D1 and PD-L1 was performed.
Material and Methods: The clinicopathological parameters like age, gender, histological type, regional lymph node status, lymphovascular invasion, perineural invasion, and pathological stage were compared and correlated with Cyclin D1 and PD-L1 expression.
Results: Positive Cyclin D1 and PDL1 expression were found in 50% and 70% cases of gastric carcinoma, respectively. Cyclin D1 expression showed statistically significant correlation with anemia, regional lymph node status, and lymphovascular invasion. PD-L1 and Cyclin D1 expression showed statistically significant association between them (p value-0.0006).
Conclusion: Cyclin D1 and PDL1 are important biomarkers in gastric carcinoma. Their contribution towards prediction of progression and prognosis, along with newer therapeutic modalities, is of immense importace in these patients. A statistically significant correlation was found between these two markers.
Keywords: Combined positive score, cyclin D1, gastric carcinoma, gastrectomy, immunohistochemistry, PD-L1