Expression of Her2-Neu in Primary Gastric and Gastroesophageal Adenocarcinoma: An Experience from a Tertiary Center in South India

  SFX Search  Permissions and Reprints Abstract Roopa Rachel Paulose

Gastric cancer is one of the most commonly occurring cancers worldwide, often presenting at an advanced stage. Combining targeted therapy with chemotherapeutic agents can enhance and extend the survival of these patients. This 4-year retrospective study aims to assess the prognostic role of Her2-Neu expression in gastric and gastroesophageal (GE) cancer. Clinicopathological features, histological type (Lauren classification) of adenocarcinoma, and Her2 immunohistochemical expression were correlated with disease-free and overall survival in 114 patients. A Her2 score of 0 and 1+ indicated negativity, while 3+ marked positivity. For cases with a 2+ score, fluorescent in situ hybridization (FISH) was conducted for definitive categorization. Statistical analysis employed IBM SPSS version 20.0 software. Among 114 patients, 13 displayed strong Her2-Neu immunopositivity (3 + ), 9 scored 2 + , and 92 were negative (0 [89] and 1+ [3]). FISH classified 4 and 5 cases as positive and negative, respectively. Most (64.7%) Her2-Neu-positive tumors occurred in the proximal stomach/GE junction (GEJ) and exhibited intestinal morphology (94.1%) with moderate differentiation (p-value < 0.05). Notably, 76.5% of Her2-Neu-positive patients exhibited advanced-stage disease with nodal/distant metastasis. The average disease-free survival was 15.4 months (standard error: 3.55) for positive Her2-Neu expression and 22.07 months (standard error: 1.364) for negative expression. The mean overall survival was 21.14 months (standard error: 3.702) for positive expression and 23.91 months (standard error: 1.474) for negative expression. Her2-Neu expression in gastric/GEJ adenocarcinomas correlates with reduced survival. Evaluating Her2-Neu in proximal gastric/GEJ cancers displaying low-grade intestinal morphology serves as both a predictive and prognostic indicator.

Keywords gastric cancer - gastroesophageal adenocarcinoma - Her2-Neu - targeted therapy - trastuzumab Note

National conference as oral presentation and included in list of oral abstracts: APCON 2019: List of Oral Abstracts 2019. Indian J Pathol Microbiol 2019;62, suppl S1:2–5. Journal ID number (OP No.): OP37.


Availability of Data and Material

The authors confirm that the data supporting the findings of this study are available within the article in form of tables.


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Obtained.


Authors' Contribution

The study's conception and design saw significant input from R.R.P., A.D., and V.J. A.D., D.A., and D.S. were responsible for data acquisition. Data analysis and interpretation were carried out by A.D., R.R.P., N.K., and R.B. A.D., R.R.P., and W.J. were involved in drafting and revising the article for substantial intellectual content. The final version approval for publication rests with R.R.P.

Publication History

Article published online:
27 September 2023

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