HER2 expression in gastric cancer: Rare, heterogeneous and of no prognostic value - conclusions from 924 cases of two independent series.
HER2 expression in gastric cancer: Rare, heterogeneous and of no prognostic value - conclusions from 924 cases of two independent series.
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DOI：
10.3233/clo-2009-0497
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发表时间：
2010
期刊：
影响因子：
--
通讯作者：
Müller W
中科院分区：
文献类型：
--
作者：
Grabsch H;Sivakumar S;Gray S;Gabbert HE;Müller W
背景：胃癌（GC）患者的生存率很低，曲妥珠单抗等生物制剂尚未常规用于这些患者。关于HER2表达及其在GC中的临床相关性的现有数据仍然有限且有争议。 方法：采用免疫组化法检测418例来自德国和506例来自英国的胃癌组织中HER2的表达。将结果与临床病理参数和患者生存率进行比较。 结果：在所有GC中，不到10%的肿瘤细胞中HER2表达超过5%，其中91%为肠型GC。在这两个系列中，没有发现HER2表达，患者生存或TNM分期之间的关系。观察到显著的瘤内异质性。 结论：这是迄今为止规模最大的研究，在两个独立的系列中证明HER2表达与胃癌患者预后无关，并且只有非常小的肠型GC亚组可能对HER2靶向治疗有潜在反应。由于胃癌中HER2表达的显著肿瘤内异质性，治疗前内镜活检中的HER2检测容易出现假阴性结果。
Background: Patients with gastric cancer (GC) have a poor survival and biologicals such as Trastuzumab have not been used routinely in these patients. Existing data on HER2 expression and its clinical relevance in GC are still limited and controversial. Methods: HER2 expression was investigated by immunohistochemistry in 418 GC from Germany and 506 GC from England. Results were compared to clinicopathological parameters and patient survival. Results: Less than 10% of all GC showed HER2 expression in more than 5% of tumour cells and 91% of these were intestinal type GC. In both series, no relationship was found between HER2 expression, patient survival or TNM stage. Marked intratumoural heterogeneity was noted. Conclusions: This is the largest study to date demonstrating in two independent series that HER2 expression is not related to gastric cancer patient prognosis and that only a very small subgroup of intestinal type GC may potentially respond to HER2 targeting therapy. Due to prominent intratumoural heterogeneity of HER2 expression in GC, HER2 testing in endoscopic biopsies before treatment will be prone to false negative results.