Research Papers:
Prognostic implications of HER2 heterogeneity in gastric cancer
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Abstract
Shigenobu Motoshima1,2, Koji Yonemoto3, Hideki Kamei4, Michi Morita5 and Rin Yamaguchi6
1Biostatistics Center, Graduate School of Medicine, Kurume University, Kurume, Fukuoka, Japan
2Department of Clinical Laboratory, Kokura Medical Center, Kitakyushu, Fukuoka, Japan
3Advanced Medical Research Center, Faculty of Medicine, University of the Ryukyus, Nishihara, Okinawa, Japan
4Department of Surgery, Japan Community Health Care Organization Kurume General Hospital, Kurume, Fukuoka, Japan
5Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan
6Department of Pathology and Laboratory Medicine, Kurume University Medical Center, Kurume, Fukuoka, Japan
Correspondence to:
Rin Yamaguchi, email: [email protected]
Keywords: gastric cancer; HER2; intratumoral heterogeneity; prognosis; trastuzumab
Received: July 11, 2017 Accepted: January 09, 2018 Published: January 18, 2018
ABSTRACT
The prognostic implications of human epidermal growth receptor 2 (HER2) heterogeneity in gastric cancer (GC) are not well established. Therefore, the aim of the present study was to determine to the effect of HER2 status on the prognosis of GC patients. We retrieved data on 248 pathologically-confirmed, consecutive patients with primary adenocarcinoma of the stomach or gastro-esophageal junction who underwent surgical resection at Kurume University Medical Center between July 2000 and December 2012. HER2 status was classified as HER2 positive or negative and HER2 heterogeneity or homogeneity. The endpoint was overall survival (OS), which was compared using the generalized Wilcoxon test. HER2 status was positive in 36 patients (14.5%) and negative in 212 patients (85.5%). Among the 36 HER2 positive patients, 25 patients (69.4%) had HER2 heterogeneity and the remaining 11 patients (30.6%) had HER2 homogeneity. Among the 141 patients with stage III or IV disease, the prognosis of the HER2 homogeneity group was significantly worse than that of the HER2 heterogeneity group (p = 0.019; median OS 193 and 831 days, respectively). The prognosis was not significantly different between the HER2 positive group and the HER2 negative group (p = 0.84; median OS 552 and 556 days, respectively). The present study was conducted with small samples, however, the results of the study suggest that HER2 homogeneity but not HER2 positivity may represent a prognostic indicator in GC.
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