Lago Nieves Martínez, Villar María Vieito, Ponte Rafael Varela, Nallib Ihab Abdulkader, Alvarez Juan José Carrera, López José Ramón Antúnez, López Rafael López, Iruegas María Elena Padin
Medical Oncology Department, University Hospital A Coruña, 15006 A Coruña, Spain.
GU, Sarcoma and Neuro-oncology Unit, Vall d'Hebron University Hospital, 08035 Barcelona, Spain.
Ecancermedicalscience. 2020 Mar 24;14:1020. doi: 10.3332/ecancer.2020.1020. eCollection 2020.
HER2 status is a predictive biomarker of response to trastuzumab in advanced gastric or gastroesophageal junction (GEJ) adenocarcinoma. However, there is relatively little known about the role of HER2 in resected gastric or GEJ adenocarcinoma in the Western population.
Retrospective, observational, single centre study of patients with gastric or GEJ adenocarcinoma undergoing surgery with curative intent between January 2007 and June 2014 in the University Hospital Complex of Santiago de Compostela. The expression of HER2 was determined by immunohistochemistry (IHC) using DAKO-HercepTest™ and gene amplification with DuoCISH using a DAKO-DuoCISH kit. The study of HER2 expression and amplification was carried out in all the patients and it was correlated with classic clinicopathological parameters, survival and recurrence pattern.
106 patients were included. HER2 expression was as follows: 71.7% HER2 negative, 21.7% HER2 equivocal and 6.6% HER2 positive, or with HER2 overexpression. 13.2% of patients (14/106) had HER2 amplification by DuoCISH. A significant association was seen between overexpression and amplification of HER2 ( < 0.001).HER2 positivity was associated with the intestinal subtype ( = 0.010) and a low grade of differentiation ( = 0.018). Likewise, HER2 was significantly associated with a worse prognosis: overall survival (OS) 32.3 months HER2 positive versus 93.9 months HER2 negative (HR 0.42; confidence interval 95% 0.18-0.93; = 0.028); and the presence of distant metastasis without accompanying locoregional recurrence ( = 0.048).
HER2 status defines a subgroup with differentiated clinicopathological characteristics, worse prognosis and distant dissemination, without accompanying locoregional recurrence, in patients with resected gastric or GEJ adenocarcinoma operated on in a Western population.
HER2状态是晚期胃癌或胃食管交界（GEJ）腺癌中曲妥珠单抗反应的预测生物标志物。然而，在西方人群中，关于HER2在切除的胃癌或GEJ腺癌中的作用相对知之甚少。
对2007年1月至2014年6月在圣地亚哥德孔波斯特拉大学医院综合体接受根治性手术的胃癌或GEJ腺癌患者进行回顾性、观察性、单中心研究。使用DAKO-HercepTest™通过免疫组织化学（IHC）和使用DAKO-DuoCISH试剂盒通过双色原位杂交（DuoCISH）测定HER2的表达。对所有患者进行HER2表达和扩增研究，并将其与经典的临床病理参数、生存率和复发模式相关联。
纳入106例患者。HER2表达情况如下：71.7%为HER2阴性，21.7%为HER2不确定，6.6%为HER2阳性或HER2过表达。13.2%的患者（14/106）通过DuoCISH检测到HER2扩增。HER2过表达与扩增之间存在显著关联（<0.001）。HER2阳性与肠型（=0.010）和低分化程度（=0.018）相关。同样，HER2与较差的预后显著相关：HER2阳性患者的总生存期（OS）为32.3个月，HER2阴性患者为93.9个月（风险比0.42；95%置信区间0.18 - 0.93；=0.028）；以及存在远处转移且无局部区域复发（=0.048）。
在西方人群中接受手术的切除胃癌或GEJ腺癌患者中，HER2状态定义了一个具有不同临床病理特征、较差预后和远处播散且无局部区域复发的亚组。
