Department of Gastroenterology and Hepatology, First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China.
Department of Gastroenterology, Air Force Medical Center, Beijing, 100142, China.
BMC Gastroenterol. 2022 May 13;22(1):238. doi: 10.1186/s12876-022-02309-7.
Studies have confirmed the prognostic value of the expression status of human epidermal growth factor receptor 2 (HER2) in advanced gastric cancer. However, its role in early gastric cancer (EGC) remains largely unknown. This study explored the association between HER2 overexpression and clinical outcomes of patients with EGC.
A total of 211 patients who had undergone endoscopic treatment for pN0 EGC were enrolled. The HER2 expression status was assessed using immunohistochemistry (IHC).
The prevalence of HER2 overexpression was 14.2%. HER2 overexpression showed a significant correlation with tumor location (P = 0.033). Multivariate analysis showed that HER2 overexpression was significantly associated with an increased risk of tumor recurrence in pN0 EGC (hazard ratio [HR] = 3.97; 95% confidence interval [CI] 1.30-12.14; P = 0.016) but not overall survival (OS) or disease-specific survival (DSS). Of the included patients, age was associated with OS (HR = 1.11; 95% CI 1.04-1.18; P = 0.002], whereas lymphovascular invasion was significantly associated with poor DSS (HR = 33.66; 95% CI 3.05-371.25; P = 0.004).
This study shows that HER2 overexpression is significantly associated with tumor recurrence in pN0 EGC. Hence, Her2 testing at diagnosis is important and differential treatment and/or follow up strategies for patients with Her2 overexpression may merit future study.
研究已经证实人类表皮生长因子受体 2（HER2）的表达状态在晚期胃癌中的预后价值。然而，其在早期胃癌（EGC）中的作用在很大程度上尚不清楚。本研究探讨了 HER2 过表达与 EGC 患者临床结局的关系。
共纳入 211 例接受内镜治疗的 pN0 EGC 患者。采用免疫组织化学（IHC）评估 HER2 表达状态。
HER2 过表达的发生率为 14.2%。HER2 过表达与肿瘤位置显著相关（P=0.033）。多因素分析显示，HER2 过表达与 pN0 EGC 患者肿瘤复发风险增加显著相关（危险比[HR] = 3.97；95%置信区间[CI] 1.30-12.14；P=0.016），但与总生存（OS）或疾病特异性生存（DSS）无关。在纳入的患者中，年龄与 OS 相关（HR = 1.11；95% CI 1.04-1.18；P=0.002），而血管淋巴管侵犯与较差的 DSS 显著相关（HR = 33.66；95% CI 3.05-371.25；P=0.004）。
本研究表明，HER2 过表达与 pN0 EGC 患者的肿瘤复发显著相关。因此，在诊断时进行 Her2 检测很重要，对于 Her2 过表达的患者，可能需要采用差异化的治疗和/或随访策略，值得进一步研究。
