Evaluation of PECAM-1 Expression and Microvessel Density in Gastric Adenocarcinoma: a Cross-sectional Study

Background Gastric adenocarcinoma is the fifth most prevalent malignancy globally and ranks sixth in Bangladesh, representing a significant oncological and public health challenge. Gaining in depth knowledge about the tumor microenvironment, particularly the mechanisms of tumor-induced angiogenesis, is essential for the development of more precise and effective targeted therapies. Microvessel density (MVD) serves as a widely recognized measure of angiogenic activity and can be reliably assessed using immunohistochemical staining for PECAM-1 (CD31), a highly specific marker of vascular endothelial cells. Methods This cross-sectional observational study was conducted in the Department of Pathology, Satkhira Medical College, from April 2024 to March 2025. A total of 50 cases of invasive gastric adenocarcinoma were included. Routine Hematoxylin and Eosin (H&E) staining was performed for Lauren classification. Immunohistochemistry for PECAM-1 was conducted to highlight microvessels. Result Among 50 cases, intestinal-type adenocarcinoma was more frequent than diffuse type. High MVD was observed in 58.1% of intestinal-type cases and 36.8% of diffuse-type cases. The difference in MVD between intestinal and diffuse types was statistically significant (p < 0.05), suggesting higher angiogenic activity in intestinal-type tumors. Conclusion This study demonstrates that PECAM-1 positive MVD is significantly higher in the intestinal subtype of gastric adenocarcinoma compared to the diffuse subtype. These findings indicate a more angiogenically active tumor microenvironment in intestinal-type tumors, potentially correlating with greater invasive potential and metastatic behavior. PECAM-1 immunostaining provides a valuable tool for quantifying tumor angiogenesis and may serve as a prognostic marker or a basis for anti-angiogenic therapeutic targeting in gastric cancer management.