Her-2/Neu Expression in Stomach and Gastro-Oesophageal Junction Carcinoma in Endoscopic Biopsy Specimens

Abstract

BACKGROUNDPrognosis of patients with advanced inoperable carcinoma of stomach and gastro-oesophageal junction remains dismal with palliative chemotherapy. In spite of extensive efforts, the five-year survival rate of these patients worldwide is 20%. The main problem with chemotherapy is its toxicity and thus the management of these patients is very complex. These patients also have associated comorbidities. Therefore, there is a need to understand the molecular biology of these malignancies and develop personalised, specialised and molecular targeted therapy. Hence, we planned this study to evaluate the expression of HER-2/neu in carcinoma of stomach and gastro-oesophageal junction. MATERIALS AND METHODSThis was an observational study from January 2010 to December 2016 wherein all cases of carcinoma of stomach and gastrooesophageal junction were retrieved and reviewed. Immunohistochemistry for HER-2/neu protein was done. Statistical analysis was done using SPSS 10.0 windows student version {SPSS Inc., 233 South Wacker Drive, 11 th Floor, Chicago, IL 60606-6412}. RESULTSThe age of patients varied from 34 to 72 years and mean age was 58.5 years. The common clinical presentation was dyspepsia and regurgitation (82.4%). Of total 85 cases, the grade of HER-2/neu expression was as follows: 0 in 65 (76.47 %) cases, 1+ in 2 (2.3%) cases, 2+ (equivocal) in 4 (4.70 %) cases and 3+ in 14 (16.47 %) cases. CONCLUSIONAssessment of HER-2/neu gene amplification by FISH technique and HER-2/neu protein overexpression by immunohistochemistry should be done in all patients with gastric and gastro-oesophageal carcinoma especially inoperable cases so that these patients are treated with molecularly targeted therapy.