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胃切除术后标本中 HER2 的表达:是否具有预后价值?

HER2 in resected gastric cancer: Is there prognostic value?

机构信息

Department of Surgery, Division of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.

出版信息

J Surg Oncol. 2014 Feb;109(2):61-6. doi: 10.1002/jso.23456. Epub 2013 Oct 10.

Abstract

BACKGROUND AND OBJECTIVES

The role of HER2 in patients with early stage/resected gastric cancer is controversial. This study investigates the prevalence and prognostic value of HER2 in patients undergoing curative intent resection for gastric adenocarcinoma.

METHODS

HER2 status was evaluated in 111 patients with gastric adenocarcinoma treated surgically between 1/00 and 6/11 with tissue available for analysis. Immunohistochemistry (IHC) for HER2 was graded by two blinded pathologists. IHC was scored as 0+/1+: negative, 2+: equivocal, and 3+: positive. Fluorescence in situ hybridization (FISH) for HER2 was performed on equivocal (2+) samples, and in cases of pathologist disagreement.

RESULTS

HER2 expression as measured by IHC was negative in 61 (55%), equivocal in 37 (33.3%), and positive in 13 (11.7%) cases. FISH was positive in 8 of 37 samples tested, for a total of 21 HER2-positive cases (18.9%, 95% CI 11.6-26.2%). Patients with HER2-positive tumors were less likely to have signet ring cell features (23.8% vs. 53.9%, P = 0.008). HER2 status was not associated with tumor size, location, perineural or lymphovascular invasion, margin status, nodal metastasis, or stage (P > 0.05). HER2 status was not associated with OS (P = 0.385).

CONCLUSIONS

HER2 amplification/over-expression is present in patients with resected gastric adenocarcinoma, but is not associated with the presence of adverse prognostic factors. Our results suggest HER2 is not prognostic for patients with resected gastric adenocarcinoma.

摘要

背景与目的

HER2 在早期/切除的胃癌患者中的作用存在争议。本研究旨在调查接受根治性切除术的胃腺癌患者中 HER2 的流行率和预后价值。

方法

对 2000 年 1 月至 2011 年 6 月期间接受手术治疗的 111 例胃腺癌患者的 HER2 状态进行评估,这些患者的组织可用于分析。两名盲法病理学家对 HER2 的免疫组化(IHC)进行评分。IHC 评分 0+/1+:阴性,2+:不确定,3+:阳性。对不确定(2+)样本和病理学家意见不一致的病例进行荧光原位杂交(FISH)检测 HER2。

结果

IHC 检测 HER2 表达阴性 61 例(55%),不确定 37 例(33.3%),阳性 13 例(11.7%)。对 37 例检测的样本进行 FISH 检测,阳性共 8 例,总 HER2 阳性病例 21 例(18.9%,95%CI 11.6-26.2%)。HER2 阳性肿瘤患者的印戒细胞特征更少(23.8% vs. 53.9%,P=0.008)。HER2 状态与肿瘤大小、位置、神经周围或血管侵犯、切缘状态、淋巴结转移或分期无关(P>0.05)。HER2 状态与 OS 无关(P=0.385)。

结论

在接受根治性切除术的胃腺癌患者中存在 HER2 扩增/过表达,但与不良预后因素无关。我们的结果表明,HER2 对接受根治性切除术的胃腺癌患者无预后意义。

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