PROTEIN KINASE B AS A PREDICTOR OFMETASTATIC GASTRIC ADENOCARCINOMA

Aims To study The expression of the PI3K/AKT/mTOR pathway in gastric adenocarcinoma.

Methods Enrolled Patients were divided into 2 groups, group (1) included 23 patients with metastatic gastric adenocarcinoma and group (2) included 10 patients with non metastatic disease. Liver and renal biochemical tests, CBC, H. pylori testing ,CEA , CA19-9 & metastatic radiological work up were done. Histopathologic examination and immunohistochemistry staining of samples from gastric adenocarcinoma obtained through upper GI endoscopy were done. Immunohistochemistry score for the expression of PI3K, AKT (protein kinase B) & mTOR (ranging from 0 to 12) was calculated as follows: grade of stain intensity×grade of coloration rate. A score≥4 was considered positive.

Results The age ranged from 52.5 to 70 years,66.7% were males & 33.3% were females. The antrum was the most commonly affected site (33% of cases) .TNM staging was as follows: T1N0M0 in 21.2%, T1N1M0 in 39.4%, T2N0M0 in 3%, T3N0M0 in 6.1%,T2N1M0 in 21.2% & T1N3aM0 in 9.1% of cases. The mTOR expression was positive in 54.5% of cases, AKT expression was positive in 72.7% & PI3K expression was positive in 36.4% of cases with significantly higher expression of AKT in metastatic (87%) than non metastatic disease (40%), P=0.010. AKT (protein kinase B) score was significantly higher in metastatic than non metastatic disease ,P=0.028. AKT score at cutoff value of more than 3 was a statistically significant discriminator between metastatic and non-metastatic disease, AUC=0.743,P=.014, sensitivity=87% & specificity=60% (curve).

Fig. 1

Conclusions Protein kinase B (AKT) expression may discriminate between metastatic and non-metastatic gastric adenocarcinoma.

Publication History

Article published online:
14 April 2022