THE ASSOCIATION OF C-MET EXPRESSION WITH HISTOLOGICAL SUBTYPE, DEGREE OF DIFFERENTIATION, DEPTH OF INVASION, AND NODAL STATUS IN COLORECTAL ADENOCARCINOMA AT NGOERAH HOSPITAL, DENPASAR, BALI, INDONESIAorectal Adenocarcinoma at Ngoerah Hospital, Denpasar, Bali, Indonesia

Abstrak

Background: Colorectal adenocarcinoma (CRA) exhibits biological heterogeneity that dictates disease aggressiveness and impacts patient prognosis. Although c-MET activation drives tumor progression and metastasis, its prognostic role in CRC research remains variable. The objectives of this study are to demonstrate the association of c-MET expression with histological subtype, degree of differentiation, depth of invasion, and nodal status in colorectal adenocarcinoma at Ngoerah Hospital, Denpasar.
Methods: This analytical observational cross-sectional study utilized 40 archival formalin-fixed paraffin-embedded (FFPE) tissue blocks from patients diagnosed with CRA (January 2023 to March 2026) obtained via consecutive sampling according to specific inclusion and exclusion criteria. c-MET expression was assessed using immunohistochemistry with a semi-quantitative Histo-score (H-Score) scoring method, utilizing a median value of 150 as the cut-off point. Data analysis was performed using the chi-square test, prevalence ratio (PR) calculations with a 95% confidence interval (CI), and multivariate analysis.
Results: High c-MET protein expression was detected in 57.5% of patients. No statistically significant association was observed between c-MET expression and histological subtype (p=0.893). However, significant bivariate associations were identified between c-MET expression and the degree of differentiation (p=0.003; PR=2.214; 95%CI: 1.502–3.264), depth of invasion (p=0.006; PR=2.400; 95%CI: 1.119–5.145), and nodal status (p=0.002; PR=2.850; 95%CI: 1.197–6.787). In multivariate analysis, the statistical significance of depth of invasion was lost (p=0.274) when tested alongside the degree of differentiation and nodal status. Consequently, nodal status emerged as the strongest independent factor associated with high c-MET expression.
Conclusion: c-MET expression is significantly associated with the degree of differentiation and nodal status, but shows no association with the histological subtype in CRC. Further analysis found that the depth of invasion is not an independent predictor of c-MET expression and nodal status acts as the strongest independent factor.