Department of Microbiology, Pathology and Forensic Medicine, Faculty of Medicine, The Hashemite University, Zarqa, 13133, Jordan.
Department of Pharmacology and Public Health, Faculty of Medicine, The Hashemite University, Zarqa, 13133, Jordan.
Diagn Pathol. 2023 Jun 20;18(1):75. doi: 10.1186/s13000-023-01364-2.
Human epidermal growth factor receptor 2 (HER2), a promising therapeutic target, can be mutated, amplified, or overexpressed in different malignancies, including non-small cell lung cancer (NSCLC). Although these alterations showed adverse prognostic effects in many cancers, their clinical significance in NSCLC is controversial. This study primarily assessed the prevalence of HER2 protein expression in NSCLC among Jordanian patients. In addition, the possible association between HER2 protein expression and clinicopathological variables was evaluated.
A total of 100 surgically resected NSCLC cases treated at King Hussein Cancer Center (KHCC) between 2009 and 2021 were examined for HER2 protein expression using immunohistochemistry (IHC). The American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) guidelines for breast cancer were applied to interpret the results with a final score ranging from 0 to 3+, considering a score of 3 + as overexpression. Additionally, a separate subset of patients was tested for HER2 gene mutation. Fisher's exact test was used to assess the association between HER2 scores and the other variables. Kaplan-Meier method was used to calculate survival.
Of the 100 cases, Her2 overexpression (score 3+) was detected in 2 cases (2%), score 2 + in 10 cases (10%), score 1 + in 12 cases (12%), and score 0 in 76 cases (76%). The two positive cases were one adenocarcinoma and one squamous cell carcinoma; both patients were elderly male smokers. No significant association was identified between Her2 expression and age, gender, smoking, histological subtype, grade, stage, tumor size, and lymph node status. Our findings also showed no association between Her2 expression and survival; however, advanced tumor stages and positive lymph node metastasis were significantly associated with poor overall survival. All cases tested for the Her2 mutation were negative.
Her2 overexpression is uncommon in NSCLC among the Jordanian population. However, when the same scoring criteria are used, the rates are similar to other results found in Asian cohorts. Due to our study's relatively small sample size, a larger one is required to investigate the prognostic value and the molecular associations between the different Her2 alterations.
人类表皮生长因子受体 2（HER2）是一种有前途的治疗靶点，可在多种恶性肿瘤中发生突变、扩增或过表达，包括非小细胞肺癌（NSCLC）。虽然这些改变在许多癌症中显示出不良的预后影响，但它们在 NSCLC 中的临床意义仍存在争议。本研究主要评估了约旦患者 NSCLC 中 HER2 蛋白表达的流行率。此外，还评估了 HER2 蛋白表达与临床病理变量之间的可能关联。
对 2009 年至 2021 年在侯赛因国王癌症中心（KHCC）接受手术治疗的 100 例 NSCLC 病例进行了 HER2 蛋白表达的免疫组织化学（IHC）检测。采用美国临床肿瘤学会/美国病理学家协会（ASCO/CAP）乳腺癌指南对结果进行解读，最终评分范围为 0 至 3+，评分 3+ 为过表达。此外，还对一部分患者进行了 HER2 基因突变检测。采用 Fisher 确切检验评估 HER2 评分与其他变量之间的关系。Kaplan-Meier 法用于计算生存。
在 100 例病例中，检测到 2 例（2%）HER2 过表达（评分 3+），10 例（10%）评分 2+，12 例（12%）评分 1+，76 例（76%）评分 0。阳性病例为 1 例腺癌和 1 例鳞状细胞癌，均为老年男性吸烟者。HER2 表达与年龄、性别、吸烟、组织学亚型、分级、分期、肿瘤大小和淋巴结状态之间无显著相关性。我们的研究结果还显示，HER2 表达与生存之间无相关性，但晚期肿瘤分期和阳性淋巴结转移与总体生存不良显著相关。所有进行 HER2 突变检测的病例均为阴性。
在约旦人群中，NSCLC 中 HER2 过表达并不常见。然而，当使用相同的评分标准时，其比率与亚洲队列中的其他结果相似。由于本研究的样本量相对较小，需要进行更大规模的研究来探讨不同 HER2 改变之间的预后价值和分子关联。
