Clinicopathological and p53 Gene Alteration Comparison between Young and Older Patients with Gastric Cancer


Background: Differences in clinicopathological characteristics of gastric cancer (GC) between young and olderpatients are controversial and a matter of debate. Determining the statistical significance of clinicopathologicalinformation with respect to age might provide clues for better management and treatment of GC. Materials and
Methods: A total of 103 Indian GC patients were enrolled for study and specimens were classified according to theAJCC-TNM system. Patients were grouped into two age-wise categories, young patients (<40 years; n=13) andolder patients (≥40 years, n=90). The clinicopathological features of both groups were retrospectively examinedand compared. p53 alterations were analyzed by polymerase chain reaction-single strand conformationalpolymorphism and immunohistochemistry methods at gene and protein levels respectively. The cases wereconsidered p53 over-expressed if it was present in more than 25% of the tumor cells and p53 alterations wascorrelated with the clinicopathological characteristics of the patients as well as etiological factors for GC in bothgroups.
Results: We found significant association of young patients with cancer stage (p=0.01), and very strongassociation with histology grade (p=0.064) and poorly differentiated (p=0.051) state of GC. However, neitheryoung nor elderly patients showed associations with location, gender, etiological factors and p53 expressionand alteration. Overall the male-to-female ratio of GC patients was 3.12 and the value was higher in the young(5.5) than in the older group (2.91).
Conclusions: Clinicopathological features of GC like cancer stage, celldifferentiation and histological grades were significantly different among young and old age cohorts. We observeda male predominance among the young group that decreased significantly with advancing age. More awarenessof GC onset is required to detect cancer at an early stage for successful treatment.