Title: A Study on HER2NEU Overexpresson in Gastric Adenocarcinoma

Authors: Prof. Dr Braja Mohan Mishra, Dr Bikash Chandra Pal, Dr Dharbind Kumar Jha, Dr Sudarsan Sethy

 DOI: https://dx.doi.org/10.18535/jmscr/v7i1.123

Abstract

 

Introduction: Carcinoma stomach is the 5th most common cancer worldwide. In India though the incidence is 10.6 per 100,000 population, majority present in later stages and it is the second most common cause of cancer related deaths in Indian population. Surgery is the mainstay of treatment but the majority of patients present with advanced, inoperable disease and palliative radiotherapy & chemotherapy offer a little in improving survival of patients with advanced tumours (median survival 7-10 months)[6] and situation demands newer novel drugs or  newer strategy to look for. Recent advances in molecular medicine have not only shed light on the carcinogenesis of gastric cancer but also offered novel approaches regarding prevention, diagnosis, and therapeutic intervention and HER-2 (human epidermal growth factor receptor 2) is currently in the spotlight. patients with HER2 overexpression receiving chemotherapy and trastuzumab had a significant longer median overall survival without any additional adverse side effects. HER2/neu testing and trastuzumab treatment also now becoming the standard of care for metastatic gastric cancer in few centres and HER2 has become a ‘‘hot’’ research topic.

The aim of our study was to evaluate the frequency of HER2 expression in gastric adenocarcinoma and its association with various clinicopathological entities.

Material and Methods: A consecutive prospective series of 150 patients of gastric carcinoma diagnosed on biopsy and resection specimens received in our department over a time span of 2 years (October 2016 to September 2018) were included in the study. Expression of HER2 in the histological specimen and correlation between the expression of HER2 & clinicopathological parameters (age, gender, tumour site, Lauren’s type, histological differentiation and UICC staging ) were evaluated in these patients.

Result And Analysis: Among the various clinicopathological entities HER2 positivity significantly associated in intestinal-type gastric cancers rather than diffuse/mixed-type cancers (29.6% vs 13.9%, p = 0.019), and moderate-differentiated cases 31(20.67%, p =0.01). Positive reactivity with anti cerbB-2 antibody was significantly more frequent in UICC stage-III (18%, p <0.001). But relationship of HER2 overexpression with sex, age, tumor site is not statistically significant (p > 0.05; Table 1). Within the subgroups, association of HER2 positivity was statistically more in M0 than M1(27.6% vs. 12.70%, p-value 0.028)  but there was no assosciation with depth of invasion and lymph node metastasis.

Conclusion: So we may conclude that HER-2/neu expression in gastric carcinomas may be, related to their aggressive clinical behaviour but to stamp HER2 status as an independent prognostic factor and to further define the role of Her2 expression in gastric carcinoma in Indian patients further research is required.

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Corresponding Author

Dr Sudarsan Sethy

Assistant Professor, Department of General Surgery, Vimsar, Burla, Sambalpur, Odisha, India

Mobile Number- 8895064191, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.