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HER2 positivity in gastric and esophageal adenocarcinoma: clinicopathological analysis and comparison

  • Original Article - Cancer Research
  • Published:
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Abstract

Purpose

Primary tumor classification of gastric or esophageal cancer has changed significantly with recent alterations of the tumor–node–metastasis (TNM) staging system. Considering these alterations, human epidermal growth factor receptor 2 (HER2) positivity rates were determined and compared in gastric and esophageal adenocarcinoma. Additionally, HER2 positivity in relation to other clinicopathological characteristics was evaluated.

Methods

A total of 321 patients with histologically confirmed invasive gastric or esophageal adenocarcinoma were examined for HER2 by immunohistochemy (IHC) and chromogenic in situ hybridization (CISH). IHC 3+ or IHC 2+/CISH-positive tumors were considered HER2 positive. Clinicopathological characteristics were retrospectively retrieved from the patient records.

Results

HER2 positivity was found in 50 of 321 patients (15.6 %). In univariate and multivariate logistic models, HER2 positivity rates were significantly higher in esophageal primary tumors (esophageal 25.0 % vs. gastric 7.4 %) and in intestinal histological tumor type (intestinal 22.6 % vs. diffuse/mixed 5.7 %). No significant differences in HER2 positivity were found between males and females, age below and above 65 years, biopsies and surgical specimens or advanced and early-stage disease. Using the 7th TNM edition, many tumors (30.5 % of all included tumors and 64.5 % of all esophageal primary tumors) previously classified as gastric cancer are now classified as esophageal cancer.

Conclusions

HER2 positivity occurs in 15.6 % of invasive gastroesophageal adenocarcinoma in Western patients, of which the majority is esophageal primary tumors and of the intestinal tumor type. With the introduction of the 7th TNM edition, a large number of tumors previously classified as gastric are now classified as esophageal tumors instead, with relatively high HER2 positivity rates in these esophageal primary tumors.

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Acknowledgments

This work was supported by Research Oncology Deventer Hospital, Deventer, The Netherlands and in part by Roche Pharma, Woerden, The Netherlands and Ventana Medical Systems, Inc.

Conflict of interest

The authors have declared no conflicts of interest.

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Patients were added to the database anonymously using unique patient numbers (UPN).

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Authors and Affiliations

  1. Department of Medical Oncology, Deventer Hospital, Nico Bolkesteinlaan 75, 7416 SE, Deventer, The Netherlands

    T. Koopman & A. L. T. Imholz

  2. Department of Pathology, Deventer Hospital, Deventer, The Netherlands

    M. M. Smits, M. Louwen & M. Hage

  3. Department of Gastroenterology and Hepatology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands

    H. Boot

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  1. T. Koopman
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  2. M. M. Smits
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  3. M. Louwen
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  4. M. Hage
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  5. H. Boot
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  6. A. L. T. Imholz
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Correspondence to A. L. T. Imholz.

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H. Boot and A. L. T. Imholz are the co-last authors.

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Koopman, T., Smits, M.M., Louwen, M. et al. HER2 positivity in gastric and esophageal adenocarcinoma: clinicopathological analysis and comparison. J Cancer Res Clin Oncol 141, 1343–1351 (2015). https://doi.org/10.1007/s00432-014-1900-3

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  • DOI: https://doi.org/10.1007/s00432-014-1900-3

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