Yuzuguldu Resmiye Irmak, Sagol Ozgul, Unlu Mehtat, Keskinkilic Merve, Derici Serhan, Akpinar Hale, Sarioglu Sulen
Department of Medical Pathology, Dokuz Eylül University Faculty of Medicine, İzmir, Türkiye.
Department of Molecular Pathology, Dokuz Eylül University Institute of Health Sciences, İzmir, Türkiye.
Turk J Gastroenterol. 2025 Jan 13;36(6):357-370. doi: 10.5152/tjg.2025.24488.
BACKGROUND/AIMS: Accurately determining the human epidermal growth factor receptor 2 (HER2) status is crucial in identifying suitable candidates for targeted therapy in gastric cancer, considering the cost and potential side effects of anti-HER2 treatments. This study aimed to assess HER2 overexpression/amplification prevalence in gastric and gastroesophageal cancer patients, its correlation with clinicopathological characteristics, and the consistency of HER2 status between biopsy and radical specimens.
We analyzed data from 667 specimens of 600 gastric/gastroesophageal cancer patients at Dokuz Eylül University Faculty of Medicine from 2012 to 2021. The correlation of HER2 expression and amplification status and clinicopathological parameters were assessed. Furthermore, we compared HER2 status concordance between paired biopsy-radical specimens when both endoscopic and radical materials were present. Additionally, we compared HER2 status before and after treatment in patients receiving neoadjuvant chemotherapy.
In our study, +3 HER2 immunohistochemistry results were more common in gastroesophageal junction tumors (23%). Human epidermal growth factor receptor 2 immunohistochemistry positivity and HER2 gene amplification were found to be significantly more common in males, people over 65 years of age, and intestinal morphology. Overall concordance of HER2 status between radical and biopsy materials was 95.5%.
The high HER2 concordance between the paired biopsy and radical samples holds significant importance in clinical management. This finding is particularly noteworthy since the HER2 assessment can generally be conducted on small/limited biopsy materials in routine practice. Our study is the most extensive series from Türkiye and the Balkans, which will shed light on our country's data by investigating the relationship of HER2 with clinicopathological parameters in gastric/gastroesophageal carcinomas.
背景/目的：考虑到抗HER2治疗的成本和潜在副作用，准确确定人表皮生长因子受体2（HER2）状态对于识别胃癌靶向治疗的合适候选者至关重要。本研究旨在评估胃癌和胃食管癌患者中HER2过表达/扩增的患病率、其与临床病理特征的相关性以及活检标本和根治性标本之间HER2状态的一致性。
我们分析了2012年至2021年在多库兹埃于勒大学医学院的600例胃癌/胃食管癌患者的667份标本的数据。评估了HER2表达和扩增状态与临床病理参数的相关性。此外，当同时存在内镜材料和根治性材料时，我们比较了配对的活检-根治性标本之间的HER2状态一致性。另外，我们比较了接受新辅助化疗患者治疗前后的HER2状态。
在我们的研究中，HER2免疫组化结果为+3在胃食管交界肿瘤中更为常见（23%）。发现人表皮生长因子受体2免疫组化阳性和HER2基因扩增在男性、65岁以上人群和肠型形态中明显更为常见。根治性材料和活检材料之间HER2状态的总体一致性为95.5%。
配对的活检标本和根治性标本之间HER2的高度一致性在临床管理中具有重要意义。这一发现尤其值得注意，因为在常规实践中，HER2评估通常可以在小的/有限的活检材料上进行。我们的研究是来自土耳其和巴尔干地区最广泛的系列研究，通过调查HER2与胃/胃食管癌临床病理参数的关系，将为我国的数据提供参考。
