HER2/neu expression in gastric carcinoma and its association with Helicobacter pylori infection and other clinicopathological parameters

Abstract

Gastric cancer is the 5 most common malignancy and 3 leading cause of cancer death worldwide. Most cases are diagnosed in advanced stages making treatment difficult. International regulatory agencies have recently approved trastuzumab therapy in locally advanced and metastatic gastric adenocarcinomas expressing HER2. To find HER2/neu expression in adenocarcinoma of stomach and correlate with clinicopathological features and study H.pylori positivity in HER2 positive cases. The ambispective, observational study was conducted in the department of Pathology (July 2017 to June 2019). Seventy eight cases of gastric adenocarcinoma were studied, both endoscopy guided biopsy or gastrectomy. Expression of HER2/neu and detection of Helicobacter pylori was done using immunohistochemistry. HER2 expression was correlated with clinicopathological parameters and H.pylori infection. Fisher’s exact test, chi square test and p value <0.05 was considered significant. HER2/neu was positive in 26.92% of cases, 16.67% were equivocal and 56.41% were negative. 55.13% of intestinal type were HER2 positive. Grade 1 tumor showed more HER2 positivity (42.31%). HER2 positivity was independent of other parameters like age, sex and location of tumor. H.pylori was positive in 24.36% of HER2/neu positive cases. HER2 positivity correlated with Lauren’s intestinal type and grade 1 of tumor.HER2 is an independent biomarker regardless of other clinicopathological features. Though few Her2 positive cases showed H. pylori positivity, more larger studies are required to establish statistically significant association between HER2 positivity and H.pylori infection.

Molecular Testing in Stage 4 Stomach Cancer in India: A Single-Centre Experience

“…This is within the range of earlier studies published worldwide showing positivity rates across all stages to be between 13% and 23% [7], though lesser than the overall positivity of 22.1% in the global screening program of the landmark ToGA trial [12]. While Indian studies have reported higher HER2/neu positivity rates between 26.92% and 56% in various studies across stages, the proportion of stage 4 patients in these studies was limited [8][9][10].…”

“…Since then, literature abounds with various studies reporting varying levels of HER2/neu positivity in GC cancer/gastroesophageal junction (GEJ) cancers with studies done in the decade of 2000s reporting a positivity across all stages to be between 13% and 23% based on the determination of HER2/neu overexpression by IHC [7]. Indian studies done on smaller sample sizes of less than 100 patients have shown a prevalence of HER2/neu-positive in GC across all stages to be between 26.92% and 56% [8][9][10]. HER2/neu has now been established to be a negative prognostic factor in GC with poorer survival [11].…”

The Expression of E-cadherin & HER2 in Gastric Carcinoma

“…In sum, 56 percent (n=38) of the 68 individuals investigated by Roy et al, [29] had HER2 positive test findings. In a separate analysis, Panigrahi et al [30] discovered that 26.92 percent (21 cases) were positive for Her2, 16.67 percent (13 cases) were equivocal, and 56.41 percent (44 cases) were negative.…”