HER2 OVEREXPRESSION IN ENDOSCOPIC BIOPSY SAMPLE OF GASTRIC ADENOCARCINOMA BY IMMUNOHISTOCHEMISTRY

2012 ◽  
pp. 109-118
Author(s):  
Viet Nho Le ◽  
Van Huy Tran ◽  
Cong Thuan Dang ◽  
Van To Ta
Keyword(s):  
Gastric Adenocarcinoma ◽  
Undifferentiated Carcinoma ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Endoscopic Biopsy ◽  
Her2 Overexpression ◽  
Tubular Adenocarcinoma ◽  
Signet Ring ◽  
Poorly Differentiated ◽  
Well Differentiated

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.

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
Keyword(s):  
Gastric Cancer ◽  
Undifferentiated Carcinoma ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Her2 Overexpression ◽  
Tubular Adenocarcinoma ◽  
Signet Ring ◽  
Poorly Differentiated ◽  
Ring Cell ◽  
Well Differentiated

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.

scholarly journals A Case of Poorly Differentiated Adenocarcinoma with Signet Ring Cell Carcinoma of the Duodenal Bulb: A Case Report

2017 ◽  
Vol 102 (3-4) ◽  
pp. 141-144 ◽  
Author(s):  
Kosuke Hirano ◽  
Yukinori Yamagata ◽  
Teppei Tatsuoka ◽  
Yawara Kubota ◽  
Kazuyuki Saito ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Rare Case ◽  
Case Reports ◽  
Duodenal Bulb ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Poorly Differentiated Adenocarcinoma ◽  
Signet Ring ◽  
Poorly Differentiated ◽  
Ring Cell

Duodenal cancers are rare. Histopathologically, most duodenal cancers are adenocarcinoma. Signet ring cell carcinoma (SRCC) is a rare tumor more commonly found in the stomach than at other sites in the digestive tract. SRCC is extremely uncommon in the duodenum, with most of these tumors occurring in the ampulla. Until now, there are few case reports of duodenal cancers with SRCC. To accumulate case reports, we report a rare case of nonampullary duodenal bulb SRCC. A 74-year-old man was admitted to our hospital with melena. Esophagogastroduodenoscopy (EGD) showed a duodenal bulb ulcer. He was treated with a proton pump inhibitor. However, 1 month later, he was readmitted to our hospital with epigastric pain and nausea. A second EGD examination showed an ulcer at the duodenal bulb. Biopsies taken from the ulcer showed SRCC. Distal gastrectomy and duodenal bulb resection were performed. Histologic examination of the specimen showed a type 4 lesion located from the duodenal bulb to the pyloric antrum. The tumor was composed of poorly differentiated adenocarcinoma (por) with SRCC. The distal margin of the duodenal bulb was invaded with tumor. Therefore, pancreatoduodenectomy was performed. One year after the initial operation, he is alive and had no relapse. We described a rare case of por with SRCC of the duodenal bulb. It is important to bear in mind that an ulcer following an abnormal clinical course should be biopsied, and we have to select a suitable operation in cases of duodenal bulb cancer.

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