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Updated: May 13, 2026
Multiomics Analysis of TMEM200A as a Pan-Cancer Biomarker
Published on: September 15, 2023
Heterogeneous target protein expression in synchronous multiple gastric carcinomas
Gyhyun Kang1, Ha Young Park, Sumin Ahn
1Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #50, Ilwon-dong, Gangnam-Gu, Seoul 135-710, Korea.
Objective:
To explore the target protein expression in separate tumors in a patient with synchronous multiple gastric carcinomas (SMGCs).
Study Design:
Immunohistochemistry for HER2, EGFR, and MET were performed in 282 carcinomas from 141 patients.
Results:
Of 141 patients with SMGCs, 11.3%, 23.4%, and 14.9% of cases showed HER2, EGFR, and MET protein overexpression, respectively. In SMGC cases with overexpression of target proteins in > 1 tumor, intertumoral heterogeneity was 81.3% (13/16) for HER2, 78.8% (26/33) for EGFR, and 90.5% (19/21) for MET protein. The concordance rate of HER2, EGFR, and MET expression between 2 carcinomas from the same patient was 90.8%, 81.6%, and 86.5%, respectively, with a kappa value below 0.3, indicating slight to fair agreement.
Conclusion:
We found a considerable intertumoral heterogeneity of target protein overexpression in SMGCs. Our findings support a multicentric origin for SMGC and emphasize the need to perform immunohistochemistry for all synchronous lesions.
Insights
Synchronous multiple gastric carcinomas (SMGCs) show significant intertumoral heterogeneity in HER2, EGFR, and MET protein expression. This suggests a multicentric origin and necessitates individual testing for each tumor lesion.
Area of Science:
- Gastroenterology
- Oncology
- Molecular Pathology
Background:
- Synchronous multiple gastric carcinomas (SMGCs) present unique diagnostic and therapeutic challenges.
- Understanding the molecular landscape of individual tumors within SMGCs is crucial for personalized treatment strategies.
Purpose of the Study:
- To investigate the protein expression levels of HER2, EGFR, and MET across separate tumor lesions in patients diagnosed with SMGCs.
- To assess the degree of intertumoral heterogeneity for these key target proteins within individual SMGC cases.
Main Methods:
- Immunohistochemistry was employed to analyze HER2, EGFR, and MET protein expression.
- The study included 282 carcinomas from 141 patients with SMGCs.
Main Results:
- HER2, EGFR, and MET protein overexpression was observed in 11.3%, 23.4%, and 14.9% of SMGC cases, respectively.
- High intertumoral heterogeneity was noted, with concordance rates below 0.3 kappa for HER2 (90.8%), EGFR (81.6%), and MET (86.5%) expression between synchronous tumors.
- Specific heterogeneity rates were 81.3% for HER2, 78.8% for EGFR, and 90.5% for MET in cases with overexpression in multiple tumors.
Conclusions:
- A considerable intertumoral heterogeneity in target protein expression exists within SMGCs.
- These findings support a multicentric origin hypothesis for SMGC.
- Comprehensive immunohistochemical evaluation of all synchronous gastric lesions is recommended for accurate patient management.
