Koopman T, Smits M M, Louwen M, Hage M, Boot H, Imholz A L T
Department of Medical Oncology, Deventer Hospital, Nico Bolkesteinlaan 75, 7416 SE, Deventer, The Netherlands.
J Cancer Res Clin Oncol. 2015 Aug;141(8):1343-51. doi: 10.1007/s00432-014-1900-3. Epub 2014 Dec 28.
Primary tumor classification of gastric or esophageal cancer has changed significantly with recent alterations of the tumor-node-metastasis (TNM) staging system. Considering these alterations, human epidermal growth factor receptor 2 (HER2) positivity rates were determined and compared in gastric and esophageal adenocarcinoma. Additionally, HER2 positivity in relation to other clinicopathological characteristics was evaluated.
A total of 321 patients with histologically confirmed invasive gastric or esophageal adenocarcinoma were examined for HER2 by immunohistochemy (IHC) and chromogenic in situ hybridization (CISH). IHC 3+ or IHC 2+/CISH-positive tumors were considered HER2 positive. Clinicopathological characteristics were retrospectively retrieved from the patient records.
HER2 positivity was found in 50 of 321 patients (15.6 %). In univariate and multivariate logistic models, HER2 positivity rates were significantly higher in esophageal primary tumors (esophageal 25.0 % vs. gastric 7.4 %) and in intestinal histological tumor type (intestinal 22.6 % vs. diffuse/mixed 5.7 %). No significant differences in HER2 positivity were found between males and females, age below and above 65 years, biopsies and surgical specimens or advanced and early-stage disease. Using the 7th TNM edition, many tumors (30.5 % of all included tumors and 64.5 % of all esophageal primary tumors) previously classified as gastric cancer are now classified as esophageal cancer.
HER2 positivity occurs in 15.6 % of invasive gastroesophageal adenocarcinoma in Western patients, of which the majority is esophageal primary tumors and of the intestinal tumor type. With the introduction of the 7th TNM edition, a large number of tumors previously classified as gastric are now classified as esophageal tumors instead, with relatively high HER2 positivity rates in these esophageal primary tumors.
随着肿瘤-淋巴结-转移（TNM）分期系统最近的改变，胃癌或食管癌的原发肿瘤分类发生了显著变化。考虑到这些改变，我们测定并比较了胃腺癌和食管腺癌中人类表皮生长因子受体2（HER2）的阳性率。此外，还评估了HER2阳性与其他临床病理特征的关系。
对321例经组织学证实为浸润性胃腺癌或食管腺癌的患者进行免疫组织化学（IHC）和显色原位杂交（CISH）检测HER2。IHC 3+或IHC 2+/CISH阳性的肿瘤被视为HER2阳性。临床病理特征通过回顾患者记录获得。
321例患者中有50例（15.6%）HER2呈阳性。在单因素和多因素逻辑模型中，食管原发性肿瘤（食管25.0% vs.胃7.4%）和肠型组织学肿瘤类型（肠型22.6% vs.弥漫/混合型5.7%）的HER2阳性率显著更高。在男性和女性、65岁以下和65岁以上、活检标本和手术标本或晚期和早期疾病之间，HER2阳性率没有显著差异。使用第7版TNM，许多先前分类为胃癌的肿瘤（占所有纳入肿瘤的30.5%和所有食管原发性肿瘤的64.5%）现在被分类为食管癌。
西方患者中15.6%的浸润性胃食管腺癌存在HER2阳性，其中大多数是食管原发性肿瘤且为肠型肿瘤。随着第7版TNM的引入，大量先前分类为胃癌的肿瘤现在被重新分类为食管肿瘤，这些食管原发性肿瘤的HER2阳性率相对较高。
