DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20200241

HER2/neu immunohistochemical expression in gastric carcinoma

Anjali Sadanandan, Arunraj C. N.

Abstract


Background: Gastric carcinoma is a deadly disease with high mortality. A better understanding of the molecular basis of gastric cancer has contributed to the development of rationally designed molecular targeted therapies which will improve the survival rate. A genetic alteration that could help in targeted therapy and prognostication includes Human Epidermal Growth Factor Receptor 2 (HER2/neu) overexpression in gastric carcinoma. The objective of the present study was to identify and evaluate the HER2/neu protein immunohistochemical expression in gastric cancer from biopsies and surgical resection specimens and to evaluate their correlation with histopathological features.

Methods: Total/subtotal gastrectomy specimens and gastric biopsies from a tertiary care center in South India were included in the study and assessed by light microscopy and Immunohistochemistry (IHC).

Results: HER2/neu overexpression was seen in 28.6% of gastric adenocarcinoma. HER2/neu overexpression was seen in 44.2% of intestinal-type and 20% of mixed type with none of the diffuse type exhibited HER2/neu positivity and this was statistically highly significant with p value of <0.01. HER2/neu positivity was found in 50% well-differentiated and 36.4% moderately differentiated tumors with none of the poorly differentiated tumors exhibiting HER2/neu positivity and this was statistically highly significant with p value of <0.01.

Conclusions: This study highlights the importance of the identification of HER2/neu overexpression in gastric adenocarcinoma. This will help in prognostication and identifying patients suitable for novel therapeutic interventions which will help in prolongation of survival of patients with this deadly disease.


Keywords


Gastric adenocarcinoma, Human epidermal growth factor receptor 2, Immunohistochemistry

Full Text:

PDF

References


Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018 Nov;68(6):394-424.

Hu B, El Hajj N, Sittler S, Lammert N, Barnes R, Meloni-Ehrig A. Gastric cancer: Classification, histology and application of molecular pathology. J Gastro Oncol. 2012 Sep;3(3):251.

Saghier AA, Kabanja JH, Afreen S, Sagar M. Gastric cancer: environmental risk factors, treatment and prevention. J Carcinogene Mutagene. 2013; S14:2157-2518.

Gravalos C, Jimeno A. HER2 in gastric cancer: a new prognostic factor and a novel therapeutic target. Annal Oncol. 2008 Apr 25;19(9):1523-9.

Yan SY, Hu Y, Fan JG, Tao GQ, Lu YM, Cai X, et al. Clinicopathologic significance of HER-2/neu protein expression and gene amplification in gastric carcinoma. World J Gastroenterol: WJG. 2011 Mar 21;17(11):1501-06.

Gómez-Martin C, Garralda E, Echarri MJ, Ballesteros A, Arcediano A, Rodríguez-Peralto JL, et al. HER2/neu testing for anti-HER2-based therapies in patients with unresectable and/or metastatic gastric cancer. J Clin Pathol. 2012 Aug 1;65(8):751-7.

Jung JE, Ioshii SO. Immunohistochemical assessment of HER2 expression in gastric cancer in a cohort of 118 Brazilian patients. J Brasileiro Patol Med Lab. 2013 Oct;49(5):361-7.

Iqbal N, Iqbal N. Human epidermal growth factor receptor 2 (HER2) in cancers: overexpression and therapeutic implications. Mol Biol Inter. 2014; September 7: Article ID 852748:1-9.

Xie SD, Xu CY, Shen JG, Jiang ZN, Wang LB. HER 2/neu protein expression in gastric cancer is associated with poor survival. Erratum in/mmr/12/3/4794. Mol Med Report. 2009 Nov 1;2(6):943-6.

He C, Bian XY, Ni XZ, Shen DP, Shen YY, Liu H, et al. Correlation of human epidermal growth factor receptor 2 expression with clinicopathological characteristics and prognosis in gastric cancer. World J Gastroenterol: WJG. 2013 Apr 14;19(14):2171-8.

Rakhshani N, Kalantari E, Bakhti H, Sohrabi MR, Mehrazma M. Evaluation of HER-2/neu overexpression in gastric carcinoma using a tissue microarray. Asian Pac J Cancer Prev. 2014 Jan 1;15(18):7597-602.

Mrklic I, Bendic A, Kunac N, Bezic J, Forempoher G, Durdov MG, et al. Her-2/neu assessment for gastric carcinoma: validation of scoring system. Hepato-Gastroenterol. 2012;59(113):300-3.

Hofmann M, Stoss O, Shi D, Büttner R, Van De Vijver M, Kim W, et al. Assessment of a HER2 scoring system for gastric cancer: results from a validation study. Histopathol. 2008 Jun;52(7):797-805.

Rüschoff J, Dietel M, Baretton G, Arbogast S, Walch A, Monges G, et al. HER2 diagnostics in gastric cancer-guideline validation and development of standardized immunohistochemical testing. Virchows Archiv. 2010 Sep 1;457(3):299-307.

Rajagopal I, Niveditha SR, Sahadev R, Nagappa PK, Rajendra SG. HER 2 expression in gastric and gastro-esophageal junction (GEJ) adenocarcinomas. J Clin Diag Res: JCDR. 2015 Mar;9(3):EC06-EC10.

Lakshmi V, Valluru VR, Madhavi J, Valluru N. Role of her 2 neu in gastric carcinoma-3 year study in a medical college hospital. Ind J Appl Res. 2014;4(11)47-50.

Yano T, Ochiai A, Doi T, Hashizume K, Nakanishi M, Ouchi K, et al. Expression of HER2/neu in gastric cancer: comparison between protein expression and gene amplification using a new commercial kit. J Clin Oncol. 2004;22:14S:4053.

Sekaran A, Kandagaddala RS, Darisetty S, Lakhtakia S, Ayyagari S, Rao GV, et al. HER2 expression in gastric cancer in Indian population-an immunohistochemistry and fluorescence in situ hybridization study. Ind J Gastroenterol. 2012 Jun 1;31(3):106-10.

Tewari M, Kumar A, Mishra RR, Kumar M, Shukla HS. HER2 expression in gastric and gastroesophageal cancer: Report from a tertiary care hospital in North India. Ind J Surg. 2015 Dec 1;77(2):447-51.

Lordick F, Bang YJ, Kang YK, Reyes DO, Manikhas GM, Shen L, et al. 3541 POSTER HER2-positive advanced gastric cancer: similar HER2-positivity levels to breast cancer. EJC Supplements. 2007 Sep 1;5(4):272.