Vegf protein expression in gastric cancer and associated clinical pathological features as seen at the Department of Pathology, Makerere University

Abstract

Background: Gastric cancer is the 5th most common cancer accounting for 5.7% of all cancers in the world and causes about 783,000 deaths annually. In Uganda the incidence of gastric cancer increased from 0.8 cases per 100,000 population in 1960 to 9 per 100,000 population in 2014. Despite the fundamental role of VEGF protein expression in the management of gastric cancer, its occurrence in gastric cancer cases in Uganda remains unknown. Objective: The study was aimed at identifying the prevalence of VEGF protein expression in gastric cancer and associated clinical pathological features as seen at Makerere University Pathology department. Methods: This was a cross sectional laboratory based study on conveniently sampled archived formalin fixed and paraffin embedded tissue blocks of 100 patients diagnosed with gastric adenocarcinoma at the Department of Pathology, Makerere University. Selected tissue blocks were subjected to both H & E and immunohistochemistry staining. Data analysis was done using STATA version 14 and the prevalence of VEGF protein expression was determined using proportions. The factors associated with VEGF protein expression were determined using logistic regression. Statistical significance was at p-value of 0.05 and 95% confidence interval. Results: The study included one hundred specimens, with a male to female ratio of 1.56 to 1.The mean age of patients was 59.4 and ranged from 44.5 to 73.9 years. The prevalence of positive VEGF was found to be fifty seven (57.0%) out of the total 100 cases in the study. Histologically, the tumor was categorized into Lauren and WHO classifications. It was found out that majority of the cases were intestinal Lauren subtype(79%) while diffuse subtype was 21%.Majority of the cases were tubular adenocarcinomas (52.0%), followed by papillary type adenocarcinoma (18.0%), poorly cohesive carcinoma (17.0%), mucinous adenocarcinoma(9.0%) and signet ring carcinoma(4.0%). The majority of the cases in this study were poorly differentiated (42.0%), followed by well differentiated (31.0%) and moderately differentiated (27.0%). Conclusion: The study showed that VEGF expression was significantly overexpressed in gastric adenocarcinoma tissues and this expression correlated differently with the different independent variables in this study. Therefore, VEGF may be of use as a biomarker for evaluating both the biological behaviour of tumor and the prognosis in patients with gastric adenocarcinoma.