Rajadurai Pathmanathan, Fatt Ho Kean, Ching Foo Yoke
Department of Pathology, Subang Jaya Medical Centre, Subang Jaya, Sunway Medical Centre, Monash University Malaysia, 1, Jalan SS 12/1A, 47500, Subang Jaya, Selangor, Malaysia.
Mount Miriam Cancer Hospital, Tanjung Tokong, Penang, Malaysia.
J Gastrointest Cancer. 2018 Jun;49(2):150-157. doi: 10.1007/s12029-017-9921-1.
Human epidermal growth factor receptor 2 (Erbb2/HER2) overexpression, which was previously detected in invasive breast cancer, has now been implicated in advanced gastric cancer (GC) and gastroesophageal junction cancer (GEC). A study was conducted to determine the rate of HER2 positivity in patients with locally advanced or metastatic GC and GEC in Malaysia and to assess the impact of various demographic and clinical parameters on HER2 positivity.
A total of 228 adult patients with GC or GEC were enrolled from Subang Jaya Medical Centre, Malaysia, for retrospective (210) and prospective study. All patients were subjected to the HER2 immunohistochemistry test using an FDA-approved, standardized test kit. Carcinomas scoring 2+ on immunohistochemistry were further tested with HER2 in situ hybridization (ISH) using an FDA-approved test kit.
The overall rate of HER2 positivity in the population studied was 24.6% (n = 56). The rate was significantly higher in men than in women (29.6 vs. 16.3%; p = 0.024). HER2 overexpression was significantly more common in diffuse type than in intestinal type of tumors (39.8 vs. 14.9%; p < 0.001). In our study, out of 56 samples, 44 (78.6%) were considered for gene amplification testing, out of which 40 (90.1%) samples showed gene amplification. There was no statistically significant correlation between HER2 positivity and patient age, race, tumor location, tumor differentiation, and TNM staging.
HER2 overexpression was evident in nearly 25% of the Malaysian patients with locally advanced or metastatic gastric cancer. The overexpression correlated significantly with male gender and diffuse-type tumors. The majority of the IHC-positive tumors demonstrated c-erb2 gene amplification and this finding reached statistical significance.
人表皮生长因子受体2（Erbb2/HER2）过表达先前在浸润性乳腺癌中被检测到，现在已被认为与晚期胃癌（GC）和胃食管交界癌（GEC）有关。进行了一项研究，以确定马来西亚局部晚期或转移性GC和GEC患者中HER2阳性率，并评估各种人口统计学和临床参数对HER2阳性的影响。
从马来西亚梳邦再也医疗中心招募了总共228例成年GC或GEC患者，进行回顾性研究（210例）和前瞻性研究。所有患者均使用FDA批准的标准化检测试剂盒进行HER2免疫组织化学检测。免疫组织化学评分为2+的癌组织进一步使用FDA批准的检测试剂盒进行HER2原位杂交（ISH）检测。
在所研究的人群中，HER2阳性的总体率为24.6%（n = 56）。男性的阳性率显著高于女性（29.6%对16.3%；p = 0.024）。HER2过表达在弥漫型肿瘤中比肠型肿瘤中显著更常见（39.8%对14.9%；p < 0.001）。在我们的研究中，56个样本中有44个（78.6%）被考虑进行基因扩增检测，其中40个（90.1%）样本显示基因扩增。HER2阳性与患者年龄、种族、肿瘤位置、肿瘤分化和TNM分期之间无统计学显著相关性。
在近25%的马来西亚局部晚期或转移性胃癌患者中，HER2过表达明显。这种过表达与男性性别和弥漫型肿瘤显著相关。大多数免疫组化阳性肿瘤显示c-erb2基因扩增，这一发现具有统计学意义。
