Shaik Rizwana, Venkata Renuka Inuganti, Ramamoorthy Sudhakar, Potti Ramya, Pranathi Lakshmi
Pathology, NRI Medical College, Guntur, IND.
Pathology, NRI Medical College, Guntur , IND.
Cureus. 2024 Aug 27;16(8):e67895. doi: 10.7759/cureus.67895. eCollection 2024 Aug.
Introduction Gastric carcinoma is a significant global health concern, known for its high mortality rate. HER-2 overexpression is observed in a notable proportion of gastric carcinoma and is associated with a worse prognosis. However, HER-2 expression enables targeting the protein by monoclonal antibodies that improve overall survival in HER-2-positive gastric cancers. This study aims to evaluate the HER-2 expression in gastric and gastroesophageal carcinomas. Materials and methods This observational study was conducted in the Department of Pathology, involving 60 endoscopic biopsy and resection specimens of gastric and gastroesophageal carcinomas. HER-2 expression was assessed by immunohistochemistry (IHC) based on the Trastuzumab for GAstric Cancer (ToGA) trial's scoring system. The primary outcome was HER-2 status, with statistical analysis performed to evaluate associations with various clinicopathological parameters. Results Among 60 cases, 26 (43.3%) showed HER-2 positivity. HER-2 positivity was significantly (p=0.004) associated with age, being higher in 20-39 years and ≥80 years age groups. Gender and tumor location were not significantly associated with HER-2 positivity. Moderate and poorly differentiated carcinomas exhibited higher HER-2 positivity. Histological types, tubular adenocarcinoma, and papillary adenocarcinoma showed significant (p=0.01) association with HER-2 positivity compared to other types. Conclusion HER-2 status assessment is crucial in managing gastric and gastroesophageal carcinomas. HER-2 positivity is notably higher in certain age groups and histological types particularly tubular and papillary adenocarcinoma, and in moderately to poorly differentiated carcinomas. These insights can aid in selecting appropriate gastric and gastroesophageal carcinomas that warrant HER-2 testing on IHC. Identifying gastric and gastroesophageal carcinomas that show HER2 expression may highlight potential candidates for targeted therapy.
引言
胃癌是一个重大的全球健康问题，以其高死亡率而闻名。在相当比例的胃癌中观察到HER-2过表达，并且与较差的预后相关。然而，HER-2表达使得能够通过单克隆抗体靶向该蛋白，从而改善HER-2阳性胃癌患者的总生存期。本研究旨在评估胃癌和胃食管癌中的HER-2表达情况。
材料与方法
本观察性研究在病理科进行，纳入了60例胃癌和胃食管癌的内镜活检及切除标本。基于曲妥珠单抗治疗胃癌（ToGA）试验的评分系统，通过免疫组织化学（IHC）评估HER-2表达。主要结局是HER-2状态，并进行统计分析以评估其与各种临床病理参数的相关性。
结果
在60例病例中，26例（43.3%）显示HER-2阳性。HER-2阳性与年龄显著相关（p = 0.004），在20 - 39岁和≥80岁年龄组中HER-2阳性率更高。性别和肿瘤位置与HER-2阳性无显著相关性。中分化和低分化癌显示出更高的HER-2阳性率。与其他类型相比，组织学类型为管状腺癌和乳头状腺癌与HER-2阳性有显著相关性（p = 0.01）。
结论
HER-2状态评估在胃癌和胃食管癌的管理中至关重要。HER-2阳性在某些年龄组、组织学类型（特别是管状和乳头状腺癌）以及中分化至低分化癌中显著更高。这些见解有助于选择适合进行IHC检测HER-2的胃癌和胃食管癌。识别显示HER2表达的胃癌和胃食管癌可能会突出靶向治疗的潜在候选者。
