RELATIONSHIP BETWEEN ENDOSCOPIC PROPERTIES, HISTOPATHOLOGY AND HER2 OVEREXPRESSION IN GASTRIC ADENOCARCINOMA

2011 ◽  
pp. 21-29
Author(s):  
Viet Nho Le ◽  
Van Huy Tran ◽  
Cong Thuan Dang ◽  
Van To Ta

Objective: HER2 may have a prognostic value in gastric cancer and test for HER2 overexpression help to select the patients for the targeted therapy with trastuzumab. Our aim was to study endoscopic properties, histopathology of gastric adenocarcinoma and their relationship with HER2 overexpression. Materials and Methods: Between 3/2010 and 05/2011, 64 patients with gastric cancer were tested for HER2 status by immunohistochemical staining of formalin-fixed paraffin-embedded endoscopic biopsy samples. Design: Cross-sectional study. Results: According to Borrmann, polypoid, fungating, ulcerated, and infiltrative type cancer. According to Lauren’s classification, 42.2% were intestinal, 57.8% were diffuse. According to WHO, 43.8% were tubular adenocarcinoma, 7.8% were mucinous adenocarcinoma, 17.2% were signet-ring cell carcinoma, and 31.3% were undifferentiated carcinoma. 29.7% were well-differentiated tumors, 18.8% were moderately-differentiated tumors, and 51.6% were poorly-differentiated tumors. HER2 overexpression was present in 23.5% of gastric carcinomas. 40% cardia tumors and 22% non-cardia tumors were HER2 positive. HER2 overexpressions were different between polypoid, fungating, ulcerated, and infiltrative types with rate of 30.8%, 37%, 6.3% and 0%, respectively (p = 0.04). HER2 overexpression of intestinal type tumors was higher than diffuse type tumors (37% vs 13.5%, p=0.04). HER2 overexpression in tubular adenocarcinoma, mucinous adenocarcinoma, signet-ring cell carcinoma, and undifferentiated carcinoma was 35.7%, 9.1%, 20% and 15%, respectively. 36.8% of well-differentiated tumors, 33.3% moderately-differentiated tumors, and 12.1% of poorly-differentiated tumors overexpress HER2. Conclusions: HER2 overexpression was found in 23.5% of gastric carcinomas and was associated to endoscopic properties, histopathologic type of tumors. Keywords: HER2, gastric cancer.

2012 ◽  
pp. 109-118
Author(s):  
Viet Nho Le ◽  
Van Huy Tran ◽  
Cong Thuan Dang ◽  
Van To Ta

Background and aim: HER2 overexpression by immunohistochemistry is a prognostic maker in gastric cancer and helps to select candidates benefitted from targeted therapy with trastuzumab. This study is aimed at the assessing HER2 overexpression and its relationship with endoscopic and histopathological findings of gastric adenocarcinoma. Objectives and methods: Biopsy samples from 92 gastric cancer patients were examined for HER2 status by immunohistochemical staining. Results: 6.5% of tumors were cardia tumors and 93.5% were non-cardia tumors. Using the Lauren classification, 51.1% were intestinal type and 48.9% were diffuse type. Using WHO classification, 54.3% were tubular adenocarcinoma, 7.6% were mucinous adenocarcinoma, 15.2% were signet-ring cell carcinoma, and 22.8% were undifferentiated carcinoma. 32.6% were well-differentiated, 15.2% were moderately-differentiated, and 52.2% were poorly-differentiated carcinoma. HER2 was positive in 20.7% of gastric carcinomas, 50% cardia tumors and 18.6% non-cardia tumors. HER2 positivity among polypoid, fungating, ulcerated, and infiltrative types were 38.5%, 29.7%, 9.1% and 0%, respectively. HER2 overexpression in intestinal type was higher than that in diffuse type (31.9% vs. 8.9%, p = 0.009). HER2 overexpression in tubular adenocarcinoma, mucinous adenocarcinoma, signet-ring cell carcinoma, and undifferentiated carcinoma was 28.0%, 14.3%, 7.1% and 14.3%, respectively. HER2 overexpressions were different between differentiation degrees: 30% of well-differentiated tumors, 35.7% moderately-differentiated tumors, and 10.4% of poorly-differentiated tumors (p = 0.037). Conclusions: HER2 overexpression was found in 20.7% of endoscopic biopsy sample of gastric adenocarcinoma and was associated with endoscopic gross characteristic, Lauren histologic type and differentiation degree.


2021 ◽  
Vol 11 ◽  
Author(s):  
Xiaoliang Jin ◽  
Wei Wu ◽  
Jing Zhao ◽  
Shuang Song ◽  
Chunli Zhang ◽  
...  

Signet ring cell carcinoma (SRCC) was previously thought to have a worse prognosis than differentiated gastric carcinoma (DC). However, recent studies have shown that its prognosis is related to staging. Here, we analyzed the clinicopathological features and the rate of lymph node metastasis (LNM) in 2166 patients with gastric cancer (605 early and 1561 advanced cases) who underwent gastrectomy and lymph node dissection (D2) from 2016 to 2019. The LNM rate for early and advanced cases was 18.0% and 74.2%, respectively. Regarding early cases, the LNM rate in SRCC was similar to that in DC (10% vs. 16.1%, p=0.224), and significantly lower than that in undifferentiated carcinoma (UDC; 10% vs. 23.3%, p=0.024). Tumor size, infiltration depth, pathological type, and mixed type were risk factors for LNM in early cases. Regarding intramucosal cases, the LNM rate in SRCC was similar to that in DC (4.3% vs. 3.7%, p=0.852), and significantly lower than that in UDC (11.2%). The LNM rate was significantly higher in submucosal than intramucosal cases (28.1% vs. 6.3%, p<0.001), and in early mixed cases than early pure cases (23.2% vs. 12.4%, p<0.001). Regarding early pure cases, the LNM rate in SRCC was similar to that in DC (9.3% vs. 7.2%, p=0.641), but significantly lower than that in UDC (9.3% vs. 24.7%, p=0.039). In summary, the LNM rate in early SRCC was similar to that in early DC but significantly lower than that in early UDC. Early SRCC fits with the endoscopic submucosal dissection (ESD) indication related to undifferentiated cases, and ESD may be effective. Additionally, the LNM rate was markedly higher for submucosal cases than intramucosal cases, and for mixed cases than pure cases.


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