Prognostıc Value of Increased her2 Expression in Cancers of Pancreas and Biliary Tree

Abstract

Increased HER2 expression has a prognostic, and predictive value in many solid cancer types, predominantly in breast cancer. However the effects of HER2 on survival from cancers of pancreas, gall bladder, cholangiocellular, and ampullary region are not known. In this study, the effects of increased HER2 expression on these types of cancer have been analyzed. Immunohistochemical HER2 staining was performed in 31 (44.9 %) female, and 38 (55.1 %) male patients with a mean age of 65 ± 10 years, and various parameters, mostly survival rates of patients with pancreas (n = 30; 43.5 %), gall bladder (n = 17; 24.6 %), cholangiocellular (n = 12; 17.4 %), and ampullary region (n = 10; 14.5 %) carcinomas were evaluated. Strong (3 +) membranous staining for HER2 was observed in 2 patients with gall bladder cancers (11.76 % of all gall bladder cancers). In 2.90 % of all cases strong membranous staining (2+ or 3+) was observed. Weak (1+) membranous staining was noted in one (3.33 %) pancreatic, and one cholangiocellular (8.33 %) cancer patient, and in none of the ampullary region patient membranous staining for HER2 was observed. Since only scarce number of patients demonstrated membranous staining for HER2, survival analysis was not performed on these patients. Based on cytoplasmic HER2 staining scores, the patients were divided into weakly (0-3 pts; n = 17 patients; 24.66 %), moderate (4-5 pts; n = 22; 31.88 %), and strongly (6-7 pts; n = 30; 43.46 %) stained groups. Patients whose specimens demonstrated borderline statistical significant (p = 0.052) low staining for HER2 had higher survival rates when compared with other cases. Increased HER2 expression has no prognostic, and predictive value in cancers of pancreas, biliary tract, and ampulla vateri. If HER2 will be evaluated in these types of cancer, membranous, as well as cytoplasmic staining properties should be taken into account.

HER2 Overexpression as a Poor Prognostic Determinant in Resected Biliary Tract Cancer

“…For this reason, molecular characterization is becoming crucial for the identification of potential therapeutic targets and more accurate patient stratification beyond conventional clinicopathological features. Previous studies described the incidence of HER2 alterations in different cohorts of BTC, but the clinical implication of such alteration has not been clarified [21,22].…”

Expression and Prognostic Significance of Human Epidermal Growth Factor Receptors 1, 2 and 3 in Periampullary Adenocarcinoma

“…The reported rates of HER2 overexpression in pancreatic cancer, defined as 3+ in immunohistochemical staining or gene amplification by in situ hybridization (ISH), vary from 0%-11% [ 16 – 23 ]. Similarly to other tumour types, high expression of HER2 in pancreatic cancer has been associated with a shorter survival [ 24 ], but other studies have found the opposite [ 25 ].…”

“…In tumours of the ampulla, distal bile duct and gall bladder, the frequency of HER2 overexpression has been low, and comparable to pancreatic cancer in a few small studies [ 16 , 17 , 23 ], whereas larger studies have found overexpression in 6–13% of ampullary tumours [ 27 , 28 ], and 23% and 17% of tumours of the bile duct and gall bladder [ 29 ].…”

Combined Detection of HER2, Ki67, and GSTP1 Genes on the Diagnosis and Prognosis of Breast Cancer

“…The activity of this heterodimer is advantageous over heterodimers that are formed by other members in EGFR family, causing a cascade reaction. 19,20 HER2 protein and ligand participate in physiological activities of cells to facilitate their activation, proliferation, and differentiation. 21 The occurrence, development, and invasion or metastasis of tumors is correlated with HER2 overexpression.…”