Hirose Suguru, Moriwaki Toshikazu, Yamaura Masamichi, Suganuma Daisuke, Tajima Hiroki, Sato Masashi, Enami Chiaki, Yamada Takeshi, Yamamoto Yoshiyuki, Sakamoto Noriaki, Hyodo Ichinosuke
Division of Gastroenterology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575 Japan.
Department of Pathology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki Japan.
Int Cancer Conf J. 2020 Apr 3;9(3):112-115. doi: 10.1007/s13691-020-00412-8. eCollection 2020 Jul.
A 63-year-old man had advanced poorly differentiated gastric adenocarcinoma with para-aortic lymph node metastases. No HER2 expression was observed in four endoscopic biopsies from the primary tumor. Tumors shrunk after S-1 with cisplatin treatment, and he underwent simple gastrectomy due to stenosis. Interestingly, HER2 diffusely overexpressed in the resected surgical specimen. His disease was stable with trastuzumab-containing therapy for 6.4 months. This case may suggest a selection of HER2-positive cells that were insensitive to the chemotherapy, and further study is needed for the change of intratumoral HER2 heterogeneity after chemotherapy.
一名63岁男性患有晚期低分化胃腺癌并伴有主动脉旁淋巴结转移。在取自原发肿瘤的4次内镜活检中未观察到HER2表达。经S-1联合顺铂治疗后肿瘤缩小，因狭窄他接受了单纯胃切除术。有趣的是，在切除的手术标本中HER2呈弥漫性过表达。他的疾病在含曲妥珠单抗的治疗下稳定了6.4个月。该病例可能提示选择了对化疗不敏感的HER2阳性细胞，化疗后肿瘤内HER2异质性的变化需要进一步研究。
