TY - JOUR
T1 - Human Epidermal Growth Factor Receptor-2 in Sri Lankan Gastric Carcinoma Patients with Clinicopathological Association and Survival
AU - Subasinghe, Duminda
AU - Sivaganesh, Sivasuriya
AU - Samarsekera, Ananthi
AU - Kumarasinghe, Mariyan Priyanthi
AU - Samarasekera, Dharmabandhu Nandadeva
AU - Lokuhetty, Menaka Dilani Samarwickrema
PY - 2017/9/1
Y1 - 2017/9/1
N2 - Background: HER2 protein expression indicates adverse prognosis in gastric adenocarcinoma (GCa). GCa HER2 positivity ranges from 10 to 22.8%. Similar data are scarce in South Asia and unavailable in Sri Lanka. Aim: To evaluate HER2 protein expression, its clinicopathological relationship and survival in a Sri Lankan GCa cohort. Methods: One hundred consecutive GCa patients were recruited prospectively for 2 years. Histological diagnosis was confirmed on endoscopic biopsies/gastrectomy specimens. Clinicopathological and overall survival data were collected. HER2 expression was assessed using immunohistochemistry. 2+ and 3+ scores were considered positive. HER2 expression and clinicopathological parameters were analyzed by Chi-squared test and multivariate analysis with logistic regression using SPSS-21. Kaplan–Meier method and log-rank test were used for survival analysis. Results: Study includes 56 biopsies and 44 resections. Male/female ratio was 1.9:1. Mean age of diagnosis was 61.1 years (range 32–82). Majority tumors were proximally located (58%). HER2 positivity was 9%. Even though intestinal subtype predominated HER2 positivity was mostly among diffuse variant (14.8%). In multivariate analysis, mitotic count >5/hpf, high nuclear grade and tumor necrosis were significantly associated with HER2 positivity, while poor differentiation, signet cells, extracellular mucin, perineural invasion and pathological nodal metastasis (all p < 0.05) showed a correlation in univariate analysis. Mean follow-up duration was 37.4 weeks (range 0–104). HER2 positivity was associated with a significantly lower median overall survival (p = 0.046). Conclusion: GCa HER2 positivity was 9%, associated with a lower median overall survival. Adverse histological features had a positive correlation with HER2 positivity. These histological features could direct patients for confirmatory HER2 testing in limited resource settings.
AB - Background: HER2 protein expression indicates adverse prognosis in gastric adenocarcinoma (GCa). GCa HER2 positivity ranges from 10 to 22.8%. Similar data are scarce in South Asia and unavailable in Sri Lanka. Aim: To evaluate HER2 protein expression, its clinicopathological relationship and survival in a Sri Lankan GCa cohort. Methods: One hundred consecutive GCa patients were recruited prospectively for 2 years. Histological diagnosis was confirmed on endoscopic biopsies/gastrectomy specimens. Clinicopathological and overall survival data were collected. HER2 expression was assessed using immunohistochemistry. 2+ and 3+ scores were considered positive. HER2 expression and clinicopathological parameters were analyzed by Chi-squared test and multivariate analysis with logistic regression using SPSS-21. Kaplan–Meier method and log-rank test were used for survival analysis. Results: Study includes 56 biopsies and 44 resections. Male/female ratio was 1.9:1. Mean age of diagnosis was 61.1 years (range 32–82). Majority tumors were proximally located (58%). HER2 positivity was 9%. Even though intestinal subtype predominated HER2 positivity was mostly among diffuse variant (14.8%). In multivariate analysis, mitotic count >5/hpf, high nuclear grade and tumor necrosis were significantly associated with HER2 positivity, while poor differentiation, signet cells, extracellular mucin, perineural invasion and pathological nodal metastasis (all p < 0.05) showed a correlation in univariate analysis. Mean follow-up duration was 37.4 weeks (range 0–104). HER2 positivity was associated with a significantly lower median overall survival (p = 0.046). Conclusion: GCa HER2 positivity was 9%, associated with a lower median overall survival. Adverse histological features had a positive correlation with HER2 positivity. These histological features could direct patients for confirmatory HER2 testing in limited resource settings.
KW - Adverse prognosis
KW - Gastric carcinoma
KW - HER2 expression
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=85020699151&partnerID=8YFLogxK
U2 - 10.1007/s10620-017-4647-2
DO - 10.1007/s10620-017-4647-2
M3 - Article
C2 - 28612195
AN - SCOPUS:85020699151
SN - 0163-2116
VL - 62
SP - 2498
EP - 2510
JO - Digestive Diseases and Sciences
JF - Digestive Diseases and Sciences
IS - 9
ER -