Evaluation of ?-Catenin Expression in Relation to Staging and Grading of Colorectal Carcinoma ??? A Study Conducted in Jubilee Mission Medical College and Research Institute, Thrissur

Author(s): Rashifa Vakiyath1, Jeena Varghese Chimmen2, Kizhake Varium Praveen3, Abhijith Valsalan4

Colorectal carcinoma is the most frequently encountered malignancy worldwide.
The main cause of mortality associated with colorectal malignancy is tumour
invasion and metastasis. The major genomic alteration that has been found in
colorectal carcinoma is mutation in the adenomatous polyposis gene. Mutated APC
causes unrestricted action of the Wnt signalling pathway which results in
accumulation of the β - catenin protein in the nucleus responsible for cell
proliferation, differentiation and enhanced survival of colorectal epithelial cells.
Role of β - catenin expression as a prognostic marker needs to be studied. It will
help in aiding the possibility of the future of anti β - catenin targeted chemotherapy
for the treatment of colorectal cancers.
A total of 85 samples from histopathologically proven cases of adenocarcinoma
colon were taken. Histomorphological features and their immunohistochemical
expression of β - catenin were studied. Data thus obtained was analysed using
SPSS version 25. Histopathological diagnosis is considered as the gold standard.
Among the 85 samples of adenocarcinoma 9 case were stage T1 tumours, 24 were
stage T2. 31 cases were stage T3, and 21 colorectal cancers were stage T4.
Statistically significant correlation was obtained between tumour stage and β -
catenin expression. (P value = < 0.001) With regard to tumour grade 24 out of
85 cases were well differentiated and 45 were moderately differentiated, 16 cases
were poorly differentiated. Correlation of tumour grading and β - catenin
expression also were statistically significant (P value = < 0.001). 45 out of 85
cases were having no nodal metastasis. 22 cases showed metastasis in 1 to 3
lymph nodes. 18 cases were N2. No statistically significant correlation was
obtained between lymph node status and β - catenin expression. (P value = 0.003)
In this study the membranous, cytoplasmic and nuclear scores of β - catenin shows
the linear progression with the advancing stages of colorectal carcinoma. So β -
catenin can be used as a prognostic marker in malignant colorectal neoplasm.