CORRELATION BETWEEN P53 GENE POLYMORPHISM AND H PYLORI INFECTION IN ENDOSCOPIC BIOPSIES OF SUSPECTED CASES OF ESOPHAGEAL CANCER

Abstract

BACKGROUND: Esophageal cancer is of two main types (a) Esophageal squamous cell carcinoma (ESCC) and (b) Esophageal adenocarcinoma (EA). Esophageal squamous cell carcinoma accounts for the majority of cases (>90%), especially in the Asian esophageal cancer belt. Helicobacter pylori infection has shown a consistent pattern of association with esophageal adenocarcinoma (EA), especially in the western world. The large majority of studies have found a protective association and the results of recent meta-analyses showed that H. pylori colonization of the stomach is associated with a nearly 50% reduction in the risk of esophageal cancer, especially esophageal adenocarcinoma. The p53 gene is located in human chromosome 17, it suspends the cell cycle when there is DNA damage. The p53 gene is mutated in about 50% of human cancers including breast, lung, colon, prostate, bladder, and skin. It has been suggested that the p53 codon 72 polymorphism may play a role in the susceptibility of esophageal squamous cell carcinoma.
AIM: To study the correlation between p53 gene polymorphism and H. Pylori infection in patients with esophageal cancer. To study the endoscopic findings of suspected cases of esophageal cancer
MATERIAL AND METHOD: The present prospective, cross-sectional study was conducted at the Hospital in the endoscopic unit of the Department of Surgery. The topic was passed by the Committee for Advanced Studies and Research (CASR) of the Faculty of Medicine of the University. A total of 42 patients who were suspected to be patients of esophageal cancer on endoscopic examination were included in the study. Two patients were excluded from the study as they did not fulfill the inclusion criteria for the study so a total of 40 patients were included in the study group. In the study group for the analysis. Adult patients who were referred for upper gastro-intestinal (G.I.) endoscopy to the Endoscopy Unit of the Department of Surgery were the subjects of the study.
RESULTS: A total of 40 patients who were admitted to the surgical wards for non-malignant disorders and gave informed consent were included as controls. In the control group patients’ mean age was 24.23±11.65 years with a range of 19-65 years. On histopathological examination of biopsies taken from suspicious lesions from the esophagus, the lesions were malignant, pre-malignant, and benign. Esophageal squamous cell carcinoma was the most common pathology (58%), followed by esophageal adenocarcinoma (22%). Barrett’s esophagus (6%), Dysplastic changes (4%), reflux esophagitis (8%), and fungal  infection  (2%) were the other less common lesions
CONCLUSION: Both the hypotheses were proved correct by the present study, that is, ‘The infection with Helicobacter pylori is a risk factor in esophageal cancer in the North Indian population; where the incidence of esophageal squamous cell carcinoma is higher than esophageal adenocarcinoma.‘ The p53 gene polymorphism is a risk factor in esophageal cancer as in many other cancers. Both Helicobacter pylori infection and p53 gene polymorphism were found directly related (risk factor) in esophageal cancer, however, this positive relationship was more marked in cases of esophageal squamous cell carcinoma as compared to esophageal adenocarcinoma.
KEYWORDS: Esophageal squamous cell carcinoma, Esophageal cancer, esophageal adenocarcinoma, p53 gene polymorphism.