The diagnostic value of cyclin d1, EGFR, P53 and Ki-67 in epithelial dysplasi of the gallbladder

Abstract

Objective: To quantitatively compare the expression levels of cyclin D1, epidermal growth factor receptor, Kiel-67 antigen and tumour suppressor protein P53 between gallbladder flat dysplasia and reactive epithelial changes.

Method: The retrospective, analytical, cross-sectional study was conducted from November 1, 2024, to January 5, 2025, at the Department of Pathology, Health Sciences University, Elazig Fethi Sekin City Hospital, Elazig, Turkiye, and comprised cholecystectomy specimens collected between September 2010 and October 2024. Immunohistochemical staining was performed for cyclin D1, epidermal growth factor receptor, Kiel-67 antigen and tumour suppressor protein P53. Staining intensity and percentage were analysed using histoscore calculations. Data was analysed using SPSS 20.

Results: Of the 10,509 specimens reviewed, 211(2%) were analysed; 159(75.4%) females and 52(24.6%) males with overall mean age 52.34 ±15.43 years (range: 16-87 years). There were 118(55.9%) cases of reactive epithelial changes and 93(44.1%) cases of flat dysplasia. Significant differences were observed between the groups with respect to age, epidermal growth factor receptor staining intensity, cyclin D1 staining percentage and intensity,

and Kiel-67 proliferation index (p<0.001). Cyclin D1 staining percentage, intensity and Kiel-67 expression were markedly higher in dysplastic cases, underscoring their potential diagnostic value (p<0.001). Although epidermal growth factor receptor staining intensity was significantly elevated in dysplasia (p<0.001), its staining percentage did not exhibit diagnostic significance (p=0,261). Tumour suppressor protein P53 expression showed no significant difference between reactive and dysplastic lesions (p=0.44).

Conclusion: Cyclin D1, epidermal growth factor receptor and Kiel-67 were found to be useful biomarkers for distinguishing gallbladder dysplasia from reactive epithelial changes, whereas tumour suppressor protein P53 showed limited diagnostic value.

Key Words: Gallbladder neoplasms, Reactive changes, Cyclin D1, Ki-67 Antigen, Receptor, Epidermal growth factor, Tumour suppressor protein P53.