Türkiye'deki Mide Kanserli Hastalarda C-Met Overekspresyonunun Sıklığı ve Klinikopatoloji ile Ilişkisi

Abstract

The incidence and mortality of gastric cancer has declined in developed western countries, but it is still an important public health problem in Türkiye and all over the world. Despite advances in diagnosis and treatment the 5-year survival rate of gastric cancer is less than 20% in most countries. The development of gastric cancer is a complex multistep process involving multiple genetic and epigenetic alterations of oncogenes, tumor suppressor genes, DNA repair genes, cell cycle regulators, and signaling molecules. While these molecules are identified the new targeted therapies are being developed and used in the treatment of cancer. In this study, we aimed to determine the frequency of mesenchymal epidermal transition factor ( c-met)’s overexpression in Türkiye which plays the role of gastric cancer devolepment and its association of clinicopathology. In addition, each patient was also evaluated of human epidermal growth factor receptor 2 (HER2) positivity. Between the years 2006-2011, diagnosed with stomach cancer patients files and hospital system datas were retrospectively analyzed and enrolled of 150 patients which available pathology slides. Patients were evaluated of age, sex, tumor location, tumor differentiation, Lauren classification, clinical stage, have metastases, peritoneal carsinomatosis, depth of tumor invasion, lymphovascular invasion, and survival. Pathology slides were evaluated with c-Met and HER-2 antibodies by immunohistochemical methods. The data were evaluated using descriptor and analytical statistical methods. As a result, evaluated 143 patients and c-Met found that 31.5% (n = 45) were scored as 3+, 27.3% (n = 39) as 2+, 10.5% (n = 15) as 1+ and 30.8% (n = 44) were negative. C-met which scored 2+ and 3+ has been considered overexpression (58.7%). Between those with overexpression of c-Met and dont; age, sex, tumor location, tumor differentiation, Lauren classification, clinical stage, presence of metastasis, depth of tumor invasion (T), lymphovascular invasion, and survival no statistically significant difference was found. 143 patients included in this study 9.1% of patients (n = 13) HER-2 3+, 9.8% (n = 14) 2 +, 16.1% (n = 23) 1+ and 65.0% (n = 93) were found v to be negative. HER-2 which scored 3+ has been considered overexpression. The HER-2 overexpression was associated with tumor differentiation, Lauren classification and TNM staging (p:0.003, p:0.008 and p:0,045). Between those with overexpression of HER-2 and dont; age, sex, tumor location, presence of metastasis, depth of tumor invasion (T), lymphovascular invasion, and survival no statistically significant difference was found. The rate of c-Met overexpression is 84.6% (n=11) in HER-2 3+, 64.3% (n=9) in HER-2 2+, 69.6% (n=16) HER-2 1+ and 51.6% (n=48) in HER-2 negative. The median overall survival was 21.2 ± 3.8 months in 102 patients which made survival analysis and observed a significant reduction in survival with increasing stage of the disease (p: <0.001). There was no significant difference in survival between the overexpression of c-Met and dont stage 3 and 4 groups (p:0.706 and p:0.229). The median survival was 11.6 ± 6.3 months in HER-2 overexpression stage 4 group and 11.9 ± 6.8 months in HER-2 overexpression don’t stage 4 group. There was no statistically significant difference in survival between the two groups (p:0.969).