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Abstract

PROGNOSTIC SIGNIFICANCE OF MEMBRANE ASSOCIATED HUMAN EPIDERMAL GROWTH FACTOR RECEPTOR 2 IN GASTRIC ADENOCARCINOMAS

Nisha Raj PhD, Divya Verma PhD, Ashok Kumar MCh, Praveer Rai DM, Ram Nawal Rao MD*

Abstract

Background: The difficulty in detecting gastric cancer at an earlystage and the lack of effective therapy all contribute to the highmortality. Human epidermal growth factor receptor2 (HER2) one ofthe first molecular targeted drugs developed, is a transmembraneglycoprotein, involved in the signal transduction pathways leading tocell growth and differentiation. Clinical demand for HER2 testing israpidly increasing after the recent introduction of trastuzumab (anti-HER2 antibody) for the treatment of patients with breast cancers. Theobjective of this study was to evaluate the prognostic significance ofHER2 overexpression in gastric adenocarcinomas patients. Methods:We included 63 prospective patients with gastric adenocarcinomasdiagnosed at Sanjay Gandhi Postgraduate Institute of Medical Sciencesbetween 2015-2017. Expression of HER2 oncoprotein was evaluatedby immunohistochemistry using HER2 antibody. HER2 expression was further correlatedwith clinicopathological parameters. Results: Out of 63 cases of gastric adenocarcinoma,there were 48(76.2%) males and 15(23.8%) females with a mean age of 53.9 yrs. Moderatelydifferentiated adenocarcinoma was predominant 27(42.8%) followed by poorly differentiated24(38%) and well differentiated type 12(19%). HER2 positivity was observed in 40% of cases. The HER2 expression was evaluated as staining score of 0 in 15(24%) patients 1+ in 23(36.5%), 2+ in 16 (25.3%), and 3+ in 9(14.3%) patients. HER2 positivity was not significantly associated with gender, tumor site (antropyloric), histological subtypes, tumor differentiation and depth of infiltration (p>0.05). Conclusion: Standardized scoring criteria and accurate assessment of HER2 expression in gastric adenocarcinoma is of importance and may be helpful in the optimal selection of patients for trastuzumab (Herceptin) therapy.

Keywords: Gastric adenocarcinomas, HER2/NEU (Human Epidermal Growth Factor Receptor2), Immunohistochemistry (IHC), Haematoxylin and Eosin (H&E).


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