STM Article Repository

Background: Gastric cancer has always been one of the most prevalent causes of cancer-related death and continues to be a major public health issue. Gene alterations are required for the development of gastric cancer, which are influenced by environmental and host factors.

Aim: This study aimed to explore the status of alteration of the three genes-P53, HER2, and hMlH1 in gastric adenocarcinoa and to find out their association with H. pylori infection and clinicopathological factors of the operated patients.

Methods: This was a cross-sectional study. Endoscopically biopsied and histopathologically confirmed as adenocarcinoma stomach patients were admitted for surgical intervention in the department of Surgical Oncology in National Institute of Cancer Research and Hospital Mohakhali, Dhaka, Bangladesh. For genetic (P53 and hMLH1) study of the gastrectomized tissue DNA extraction and optimization, we performed PCR amplification and DNA sequencing. HER2 was studied by immunochemical technique. The results were matched with tumor status, age and sex, smoking, and H. pylori antibody status of the patients to find their association.

Results: The mean age of the patients was 52.91 (±13.94) years. Among the 45 patients selected for genetic tests, 12 aged 40 or more and 33 aged over 40. Among the genes, 33(73.3%) in P53 and 17(37.7%) in hMLH1 were mutated and 11(24.2%) in HER2 were found to be overexpressed. Chi square and regression analysis showed that they all had associations with H. pylori positivity (P < 0.05, odds ratio >1). hMLH1 was associated with the location of the tumor, smoking, sex, blood group, and age, and P53 was found to be affected by extra salt intake, sex, blood group, and age of the patients (P≤0.05). This study explored the relationship of H. pylori infection with the genetic changes in cancer patients, which would be a milestone in the cancer research in this country.

Conclusion: Genetic mutation was found in nearly all the patients with gastric cancer, which was significantly associated with H. pylori infection. Mass eradication of this organism might play a role in reducing cancer incidence in Bangladesh.