Rima F A, Hussain M, Haque N, Dewan R K, Rahman N, Jinnah M A, Jeba R, Chowdhury F
Dr Fahmida Akter Rima, Lecturer, Department of Pathology, Dhaka Medical College (DMC), Dhaka, Bangladesh.
Mymensingh Med J. 2017 Apr;26(2):372-379.
Gastric carcinoma is a biologically heterogenous disease and survival varies among the patients with same stage. Recent studies have shown that a subset of gastric and gastroesophageal junction adenocarcinoma over express the HER2/neu protein and these patients can be treated by monoclonal antibody against HER2/neu protein. The purpose of this study was to detect the frequency of HER2 expression in gastric and gastroesophageal junction adenocarcinoma and to evaluate the relationship between HER2 expression and clinicopathological features in these patients. This descriptive cross sectional study was carried out at the Department of Pathology, Dhaka Medical College, from January 2013 to December 2014. A total of 130 patients with primary gastric and gastroesophageal junction adenocarcinomas were included in this study. All the cases were evaluated for routine histological examination and immunohistochemical examination was done for HER2/neu protein. Among the 130 cases, HER2 over expression was found in 12.3% cases and was more frequent in gastroesophageal junction (28%) than in gastric carcinoma (8.6%) (P=0.026). HER2 positivity was found significantly more in intestinal type carcinoma (19%), papillary carcinoma (63%) and in fungating growth pattern (P=0.003, 0.001 and 0.001 respectively). HER2 expression was also positive in grade-I or grade-II tumor but negative in grade-III tumor (P=0.001). No significant association of HER2 expression was found with age, sex, lymph node metastasis and extent of tumor. In conclusion it can be stated that gastric and gastroesophageal junction adenocarcinoma of intestinal type or papillary and tubular type with well to moderate differentiation can be targeted for therapy using Herceptin.
胃癌是一种生物学上异质性的疾病，同一分期的患者生存率各不相同。最近的研究表明，一部分胃和胃食管交界腺癌过度表达HER2/neu蛋白，这些患者可以用抗HER2/neu蛋白的单克隆抗体进行治疗。本研究的目的是检测胃和胃食管交界腺癌中HER2表达的频率，并评估这些患者中HER2表达与临床病理特征之间的关系。这项描述性横断面研究于2013年1月至2014年12月在达卡医学院病理科进行。本研究共纳入130例原发性胃和胃食管交界腺癌患者。所有病例均进行常规组织学检查，并对HER2/neu蛋白进行免疫组化检查。在130例病例中，12.3%的病例发现HER2过度表达，胃食管交界（28%）比胃癌（8.6%）更常见（P=0.026）。HER2阳性在肠型癌（19%）、乳头状癌（63%）和蕈伞状生长模式中显著更多（分别为P=0.003、0.001和0.001）。HER2表达在I级或II级肿瘤中也为阳性，但在III级肿瘤中为阴性（P=0.001）。未发现HER2表达与年龄、性别、淋巴结转移和肿瘤范围有显著相关性。总之，可以说肠型或乳头状和管状型、分化良好至中等分化的胃和胃食管交界腺癌可以用赫赛汀作为治疗靶点。
