title: Prognostic Significance of HER-2 and p53 Expression in Gallbladder Carcinoma in North Indian Patients.
abstract: OBJECTIVE
  Proto-oncogenes (HER-2) and tumor suppressor genes (p53) are commonly deregulated in gallbladder cancer (GBC). Available literature discloses skewed data from endemic Asian countries, especially north India. This study evaluates the prognostic significance of HER-2 and p53 in GBC patients from two major hospitals.
  
  
  METHODS
  Sixty resectable tumor and control specimens were prospectively collected from December 2012 to January 2016. Immunohistochemical staining was done using monoclonal antibodies to semiquantitatively evaluate HER-2 and p53 protein expression. The criterion for HER-2 positivity was set at >30% tumor cells showing complete, membranous staining while p53 positivity was established at <50% tumor cells showing complete nuclear staining. Clinicopathological correlations were drawn with major clinical outcomes.
  
  
  RESULTS
  It was observed that 36.67% (22/60) tumor cases and 5% (3/60) control cases showed strong HER-2 overexpression significantly correlating with sex, T-stage, nodal spread and distant metastasis (p < 0.05), while 33.3% (20/60) positivity was observed for p53 in tumor cases and 1.7% (1/60) in control cases. Multivariate analysis showed HER-2 (p = 0.04; hazard ratio: 2.36; 95% confidence interval: 1.04-5.33) and p53 (p = 0.03; hazard ratio: 5.63; 95% confidence interval: 1.21-26.26) expression to be independent prognostic factors.
  
  
  CONCLUSIONS
  Our study thus suggests the plausible role of HER-2 and p53 expression in worse prognosis of GBC in a north Indian population.
authors: Department of Pharmaceutical Medicine, Faculty of Pharmacy, Jamia Hamdard, New Delhi, India.
authors: Anjali
authors: A
authors: Singh
authors: Pramod K
authors: PK
authors: Mishra
authors: Sundeep Singh
authors: SS
authors: Saluja
authors: Majid A
authors: MA
authors: Talikoti
authors: Pawan
authors: P
authors: Kirtani
authors: Abul Kalam
authors: AK
authors: Najmi
mesh_terms: D000230:Adenocarcinoma / Q000737:chemistry* / Q000556:secondary*; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005706:Gallbladder Neoplasms / Q000737:chemistry* / Q000473:pathology*; D006801:Humans; D007194:India; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis*; D012737:Sex Factors; D016159:Tumor Suppressor Protein p53 / Q000032:analysis*
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; D016159:Tumor Suppressor Protein p53; C508053:ERBB2 protein, human