Her2neu Expression of Gastric and Lower Esophageal Carcinoma and its Correlation with Clinicopathological Findings in Tertiary Care Hospital in Eastern India

Background: Gastric carcinomas are the fifth most common cancer worldwide and cause the second most common cancer-related deaths. Human epidermal growth factor receptor 2 (HER-2/Neu)(c-erbB2) protein overexpression in gastric cancer has been correlated to poor outcomes and a more aggressive disease. Targeted therapy against HER-2/Neu has attracted much attention recently. Comprehensive data regarding Her2neu expression in gastric carcinoma in Southeast Asia shows highly variable results and often lacks standardization. Aim/Objective: In this study, we study the expression of HER-2/Neu marker in lower esophageal and gastric carcinoma and compare it with various clinicopathological parameters and are known to have prognostic significance. Methods: One hundred and fifty cases of gastric/gastroesophageal adenocarcinomas (intestinal type) were included in the study over 2 years, and immunohistochemistry was done to evaluate Her2neu expression. Scoring was done according to the American Society of Clinical Oncology/College of American Pathologists guideline, and the finding was correlated with clinicopathological parameters. Results: The age of patients ranged from 41 years to 80 years. Gastric tumors were more common in the age group 61-70 years with mean age of 65.5 years. Gastric tumors are more common in males than females. (M:F = 3.16:1) Most common type of specimen received was partial gastrectomy (38%). Anorexia (46%) and pain abdomen (46%) were the most common presenting symptoms. Gastric tumors were common in tubular subtypes (76%) followed by mucinous subtypes (16%). Most common histopathological grading was moderately differentiated gastric adenocarcinoma (64%). Most gastric tumors were located at antropyloric area of the stomach (42%). The highest frequency of cases presented at an tumor, node, metastasis (TNM) stage that is pT(2)N(2)M(x) (32.3%). Her2neu expression was found to be score 0 in most (62%) cases, only 10% of cancers were positive (3+), 14% were equivocal (2+), and another 14% were 1+ (negative). When we correlated clinicopathological parameters such as age, sex,tumour site,gross appearance, size,depth of invasion, TNM stage,Lymphovascular invasion, perineural invasion etc. with HEr2neu expression; no statistically significant correlation was found. Conclusion: Overexpression of HER-2/Neu in gastric carcinoma can help to identify patients with reduced survival and to identify eligible candidates for targeted therapy. A larger sample size and follow-up for a longer period might shed more light on the role of the above markers in gastric carcinoma.