Cavanna Luigi, Seghini Pietro, Di Nunzio Camilla, Orlandi Elena, Michieletti Emanuele, Stroppa Elisa Maria, Mordenti Patrizia, Citterio Chiara, Vecchia Stefano, Zangrandi Adriano
Department of Oncology and Hematology, Piacenza General Hospital, I-29121 Piacenza, Italy.
Department of Epidemiology, Piacenza General Hospital, I-29121 Piacenza, Italy.
Oncol Lett. 2018 Apr;15(4):5787-5791. doi: 10.3892/ol.2018.8054. Epub 2018 Feb 14.
Central nervous system (CNS) metastases from cancers of the gastrointestinal tract (GIT) are rare, and occur in 0.16-0.69% of patients with gastric or gastro-esophageal (GE) junction cancer. Overexpression of the human epidermal growth factor 2 (HER-2) is associated with poor prognosis in the absence of HER-2-targeted therapy, and with an increased incidence of CNS metastases in patients with breast cancer. The role of HER-2 overexpression in CNS metastases is not well known in gastric adenocarcinoma. The purpose of the present retrospective study was to assess the incidence of CNS metastases and to evaluate the associations between the CNS and HER-2 status in a series of consecutive patients with gastric or GE junction cancer. Between 2007 and 2013, 300 patients with gastric cancer (GC) or gastroesophageal junction, were admitted to Piacenza General Hospital, Italy. These cases were retrospectively analyzed to evaluate CNS metastases. The metastases were diagnosed with imaging techniques performed on symptomatic patients. Gastric histological samples of patients with CNS metastases were reviewed and tested for HER-2. A total of 7 of the 300 patients (2.33%) with GC were observed to have CNS metastases and 6 (85.71%) had HER-2 positive disease. These patients exhibited a poor prognosis with a median overall survival rate of 4.1 months (range, 2.1-6.6 months). These results suggested there may be CNS recurrence susceptibility in patients with HER-2 positive GC. To the best of our knowledge, this is the first report that associates CNS metastases and HER-2 status in gastric or GE junction cancer.
胃肠道（GIT）癌的中枢神经系统（CNS）转移很少见，在胃癌或胃食管（GE）交界癌患者中的发生率为0.16 - 0.69%。在缺乏HER-2靶向治疗的情况下，人表皮生长因子2（HER-2）过表达与预后不良相关，并且在乳腺癌患者中与CNS转移发生率增加有关。HER-2过表达在胃腺癌CNS转移中的作用尚不清楚。本回顾性研究的目的是评估一系列连续的胃癌或GE交界癌患者中CNS转移的发生率，并评估CNS与HER-2状态之间的关联。2007年至2013年期间，300例胃癌（GC）或胃食管交界癌患者入住意大利皮亚琴察综合医院。对这些病例进行回顾性分析以评估CNS转移。对有症状患者进行成像技术诊断转移。对CNS转移患者的胃组织学样本进行回顾并检测HER-2。在300例GC患者中，共7例（2.33%）发生CNS转移，6例（85.71%）为HER-2阳性疾病。这些患者预后较差，中位总生存率为4.1个月（范围2.1 - 6.6个月）。这些结果表明HER-2阳性GC患者可能存在CNS复发易感性。据我们所知，这是第一份将胃癌或GE交界癌中的CNS转移与HER-2状态相关联的报告。
