Related Experiment Video
Updated: Apr 12, 2026
Gene Regulation and Targeted Therapy in Gastric Cancer Peritoneal Metastasis: Radiological Findings from Dual Energy CT and PET/CT
Published on: January 22, 2018
HER 2 Expression in Gastric and Gastro-esophageal Junction (GEJ) Adenocarcinomas
Indu Rajagopal1, S R Niveditha2, R Sahadev3
1Post Graduate, Department of Pathology, Kempegowda Institute of Medical Sciences , Karnataka, India .
Introduction:
Gastric cancer is one of the leading causes of cancer mortality in the world/India with majority being diagnosed at an advanced stage. Various chemotherapeutic regimens have modestly improved overall survival leading to quest for novel therapeutic agents. Overexpression of HER2 in many gastric cancers has lead to the advent of targeted therapy with anti HER2 antibody like Trastusumab which has improved the overall survival.
Materials And Methods:
Sixty cases of gastric adenocarcinomas (44 biopsies and 16 gastrectomies) over the past five years ( June 2009 to June 2014),were included in the study. Diagnosis was confirmed by review of slides and IHC with anti HER2 antibodies was performed using Dako Real Envision Detection system and scoring was done by Hoffmann et al., scoring system.
Results:
Of the 60 cases, majority were males (60%),with a mean age of 65.65 yrs. Tumours in antrum (76.7%) formed the major bulk. HER2 expression was observed in 26.7% of Tumours, predominantly in males (p=0.006) and intestinal type (p= 0.054). HER2 expression correlated with Tumour grade (moderately differentiated and well differentiated, p= 0.042). Tumours of gastro-esophageal junction (GEJ) showed HER2 expression in 45.5% as opposed to 22.4% in gastric location. Poorly differentiated and diffuse type of adenocarcinomas did not express HER2. Two of three Tumours from patients in the age group 31-40 y expressed HER2.
Conclusion:
Male gender, intestinal-type and moderately differentiated gastric cancers may be the ones that can be targeted for therapy using Herceptin. Though trastusumab is approved for advanced gastric and GEJ cancers, it's role in adjuvant / neo-adjuvant setting in early stages needs to be evaluated with newer agents like Pertuzumab, Bevacizumab, especially in young patients.
Insights
Human epidermal growth factor receptor 2 (HER2) is expressed in 26.7% of gastric cancers, predominantly in males and intestinal types. This finding supports targeted therapy with anti-HER2 agents like Trastuzumab for specific patient groups.
Area of Science:
- Oncology
- Gastroenterology
- Molecular Pathology
Background:
- Gastric cancer is a leading cause of mortality globally and in India, often diagnosed at advanced stages.
- Limited efficacy of conventional chemotherapy necessitates novel therapeutic strategies.
- Human epidermal growth factor receptor 2 (HER2) overexpression in gastric cancer has led to targeted therapies like Trastuzumab.
Purpose of the Study:
- To investigate the prevalence and clinicopathological correlation of HER2 expression in gastric adenocarcinomas.
- To identify patient subgroups who may benefit from HER2-targeted therapies.
Main Methods:
- Retrospective analysis of 60 gastric adenocarcinoma cases (biopsies and gastrectomies) from June 2009 to June 2014.
- Immunohistochemistry (IHC) using anti-HER2 antibodies and scoring by Hoffmann et al. system.
Main Results:
- HER2 expression was found in 26.7% of gastric tumors, more common in males (p=0.006) and intestinal type (p=0.054).
- HER2 expression correlated with moderately and well-differentiated tumors (p=0.042).
- Gastro-esophageal junction tumors showed higher HER2 expression (45.5%) compared to gastric tumors (22.4%). Poorly differentiated and diffuse types did not express HER2.
Conclusions:
- Male gender, intestinal type, and moderately differentiated gastric cancers are potential candidates for HER2-targeted therapy (e.g., Trastuzumab).
- Further evaluation of Trastuzumab's role in early-stage gastric cancer and the utility of newer agents (Pertuzumab, Bevacizumab) in specific populations, including young patients, is warranted.
Related Concept Videos
01:21Barrett Esophagus-I: Introduction
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more...
01:29Gastroesophageal Reflux Disease I: Meaning and Pathophysiology
01:25Hormones Secreted by the Stomach
Each of these hormones secreted by different enteroendocrine cells plays a unique role in digestion. Here are a few examples:
01:21Barrett Esophagus-II: Clinical Manifestations and Management
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
01:25Mucosal Barrier of the Stomach
Within parietal cells, carbonic acid is first formed through the reaction of water and carbon dioxide. The dissociation of carbonic acid releases bicarbonate and hydrogen ions. The bicarbonate...
01:17Gastritis-II: Pathophysiology
In acute gastritis, the gastric mucosa becomes swollen and red and undergoes superficial erosion. Superficial ulceration may lead to bleeding.
In chronic gastritis, persistent or repeated insults lead to chronic inflammatory changes and, eventually, thinning or atrophy of the gastric tissue.
Gastritis can stem from various causes, each...