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Clinical Significance of HER2 Overexpression in Gastric and Gastroesophageal Junction Cancers

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

In this study, we investigated the rate of human epidermal growth factor receptor 2 (HER2) overexpression in gastric (GC) and gastroesophageal junction cancers (GEJCs) and the relationship with HER2 expression and clinical, pathological parameters and prognosis.

Methods

Surgery or biopsy specimen of 598 (436 males, 162 females) patients with GC or GEJC was evaluated for the presence of HER2 overexpression by immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) methods.

Results

HER2 IHC scores were as follows: 418 (69.9 %) IHC 0, 58 (9.7 %) IHC 1+, 50 (8.4 %) IHC 2+, 72 (12 %) IHC 3+. Among 50 patients with IHC 2+, 18 (38.2 %) were FISH positive, and 29 (61.7 %) were FISH negative for HER2 amplification. Patients were regarded as HER2 positive in case of IHC 3+ disease or IHC 2+ disease with a positive FISH test result for HER2 amplification. In the primary analysis population, 90 (15 %) were considered HER2 positive. HER2 positivity was higher in intestinal GC compared to diffuse GC (16.9 vs 6.6 %, p = 0.014). HER2 positivity was significantly higher in well and moderately differentiated tumors than poorly differentiated tumors (p < 0.0001). HER2 positivity had no significant effect on median OS (23.2 vs 19.1 months, p = 0.44). But in the early stages (stages I and II), median OS of HER2-positive patients was shorter than HER2-negative patients (51.4 months vs not reach, p = 0.047). However, median OS was similar in patients with advanced stages (stages III and IV) HER2-positive and HER2-negative disease (16.2 vs 13.7 months, p = 0.72).

Conclusions

Rate of HER2 positivity is similar in Turkish patients with GC and GEJCs. HER2 positivity is associated with poor prognosis in patients with early-stage disease.

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Authors and Affiliations

  1. Department of Medical Oncology, Sakarya University Training and Research Hospital, Sakarya, Turkey

    Meltem Baykara

  2. Medical Faculty Department of Medical Oncology, Gazi University, Ankara, Turkey

    Mustafa Benekli, Selcuk Cemil Ozturk, Ugur Coskun, Aytug Uner, Ahmet Ozet & Suleyman Buyukberber

  3. Medical Faculty Department of Pathology, Gazi University, Ankara, Turkey

    Ozgur Ekinci & Eylem Pinar Eser

  4. Department of Pathology, Ankara Ataturk Training and Research Hospital, Ankara, Turkey

    Sultan Cigdem Irkkan

  5. Medical Faculty Department of Medical Oncology, Erciyes University, Kayseri, Turkey

    Halit Karaca & Metin Ozkan

  6. Department of Medical Oncology, Dr.Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey

    Umut Demirci, Fatma Paksoy Turkoz & Berna Oksuzoglu

  7. Department of Medical Oncology, Yıldırım Beyazit University Medical Faculty, Ankara, Turkey

    Muhammed Bulent Akinci & Bulent Yalcin

  8. Medical Faculty Department of Medical Oncology, Dokuzeylul University, Izmir, Turkey

    Olcun Umit Unal & Necla Demir

  9. Medical Faculty Department of Medical Oncology, Marmara University, Istanbul, Turkey

    Faysal Dane

  10. Medical Faculty Department of Medical Oncology, Gaziantep University, Gaziantep, Turkey

    Ozan Balakan & Alper Sevinc

  11. Medical Faculty Department of Medical Oncology, Inonu University, Malatya, Turkey

    Hakan Harputluoglu

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  1. Meltem Baykara
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Correspondence to Meltem Baykara.

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Baykara, M., Benekli, M., Ekinci, O. et al. Clinical Significance of HER2 Overexpression in Gastric and Gastroesophageal Junction Cancers. J Gastrointest Surg 19, 1565–1571 (2015). https://doi.org/10.1007/s11605-015-2888-y

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