Prevalence of HER2 Expression and Its Correlation with Clinicopathological Parameters in Gastric or Gastroesophageal Junction Adenocarcinoma in North-East Indian Population

Abstract

Gastric cancer is a leading health-care problem worldwide and is the fifth most common cancer in the world, with 952,000 new cases diagnosed in 2012 Worldwide 0.7 million people die of gastric cancer each year (accounts for 8.8% of all cancer-related deaths) [GLOBACON, 2012]. Gastric cancer is the second most common cancer among men and third-most among females in Asia (Rahman et al., 2014) and is the second most common cause of cancer-related deaths in India (Dikshit et al., 2012). A high incidence of gastric cancer has been reported from Southeast Asia, most commonly from Japan, China and South Korea (Ferlay et al., 2012).The age-adjusted rate (AAR) of gastric cancer among urban registries in India is (3.0-13.2) compared to the worldwide AAR (4.1-95.5) with China having the highest incidence of AAR. Amongst all the population based cancer registries in India, Papumpure district (Arunachal Abstract Objective: Human epidermal growth factor receptor 2 (erbb2/HER2) overexpression, has now been implicated in advanced gastric and gastroesophageal junction cancers. The study was conducted to determine the rate of HER2 positivity in patients with locally advanced or metastatic gastric and gastroesophageal adenocarcinoma in North-East India and to assess the impact of various demographic and clinical parameters on HER2 positivity. Methods: A total of 68 patients of age >18 years of gastric and gastroesophageal adenocarcinoma diagnosed on histopathological examination from September 2016 to February 2018 at Dr B Borooah Cancer Institute, Assam were enrolled for the observational (epidemiological) study. All patients were subjected to the HER2 immunohistochemistry test using a FDA-approved, standardized test kit. HER2 expression was correlated with various demographic and clinicopathological parameters. Results: The overall rate of HER2 positivity in the population studied was 56% (n=38). The rate was non-significantly higher in male, older age group (>60 years) and Hindu population. Similarly, HER2 positivity rate was higher in patients with well differentiated histology and was more common in patients with stage II and III diseases, but neither of the associations is statistically significant. HER2 positivity rate was significantly higher in proximal and in GEJ tumours (56% versus 44%, P=0.002). Conclusion: HER2 overexpression was evident in 56% of the North-East Indian patients with locally advanced and metastatic gastric and gastroesophageal adenocarcinoma. The overexpression correlated significantly with primary tumour site. Routine testing of gastric and gastroesophageal tumours for HER2 expression is recommended to provide a therapeutic advantage in Indian patients.

The Expression of E-cadherin & HER2 in Gastric Carcinoma

“…Motoshima et al discovered Her2 in 14.5 percent of the patients they investigated. 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.…”

“…Phan et al [31] discovered that 26.6 percent of male and 20.3 percent of female patients have HER2. Roy et al [29] confirmed that Her2 was positive in 66% of males and 36% of females with no statistical significance. Positive incidences accounted for 5% of persons above the age of 50 in our study.…”

Honokiol Suppression of Human Epidermal Growth Factor Receptor 2 (HER2)-Positive Gastric Cancer Cell Biological Activity and Its Mechanism

“…It has been confirmed that 12–35% of gastric cancers have HER2 overexpression, and HER2 is an independent prognostic factor of gastric cancer [ 21 ]. The results of Roy et al [ 22 ] showed that HER2 protein expression in patients with gastric cancer combined with lymph node metastasis was significantly higher than that in those without lymph node metastasis; HER2 protein expression in patients with infiltration reaching beyond the serosa was significantly higher than in those with infiltration within the serosa, and HER2 protein in lymph node metastasis of gastric cancer was highly expressed. Patients with HER2-positive tumors had poorer prognosis and lower 5-year survival rate.…”

Two Updates on Oesophagogastric Junction Adenocarcinoma from the Fifth WHO Classification of Tumors of the Digestive System: Alteration of Definition and Emphasis on HER2 Test.

“…With the change of scoring criteria and the de nition of oesophagogastric junction adenocarcinoma, the HER2-amplication rate exhibits a great discrepancy, which varies with an extremely wide range, from 4-53% (median, 20.2%) [11,12]. Previous studies showed that HER2-positivity rate was higher in oesophagogastric junction than gastric adenocarcinoma [13,14], while some studies suggested that the presence of HER2-expression was not associated with tumor location [15,16]. HER2-expression is heterogeneous in gastric or oesophagogastric junction adenocarcinoma, thus it's important to review the HER2 status and its correlating clinicopathological features according to the V5.0.…”