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Clinicopathological features and endoscopic findings of HER2-positive gastric cancer

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Abstract

Background

Human epidermal growth factor receptor 2 (HER2) expression in gastric cancer is highly heterogeneous. Therefore, it is important to take endoscopic samples from appropriate tumor sites.

Methods

Between January 2008 and April 2015, patients with gastric or gastroesophageal junction cancer with histologically confirmed adenocarcinoma were included. Surgical samples or endoscopic biopsy samples were examined for HER2 using immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH). Tissues were considered to be HER2 positive when either assessment revealed either an IHC score of 3+ or an IHC score of 2+ accompanied by a positive FISH result. Endoscopic findings were retrieved in all cases where available, and we examined the portion from which a biopsy was obtained.

Results

Out of the 612 patients included in the study, 104 (17%) were HER2 positive. The proportion of HER2-positive gastric tumors with differentiated (vs. undifferentiated) histology was significantly higher (29 vs. 6%, respectively; p < 0.001). The HER2-positive rate of papillary adenocarcinomas (vs. tubular) was particularly high (62%, 8/13; p = 0.023). The proportion of HER2-positive gastric tumors of Borrmann classification 0 or 1 was significantly higher than that of tumors of classified as 2, 3, or 4 (45 vs. 16%, respectively; p < 0.001). The HER2-positive rates per biopsy specimen from the superficial spreading portion, ulcer mound, ulcer bed, and mass portion were 100, 91, 45, and 100%, respectively.

Conclusions

HER2-positive gastric cancer tends to be associated with a differentiated histology, particularly papillary adenocarcinoma, and a Borrmann classification of 0 or 1 tumors. Based on these endoscopic findings, it is important to recognize the superficial spreading portion and the mass portion of gastric malignancies.

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Authors and Affiliations

  1. Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan

    Yasuhiro Oono, Kenji Takashima, Yusuke Yoda, Hiroaki Ikematsu & Tomonori Yano

  2. Division of Pathology, National Cancer Center Hospital East, Kashiwa, Japan

    Takeshi Kuwata

  3. Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan

    Kohei Shitara

  4. Gastric Surgery Division, National Cancer Center Hospital East, Kashiwa, Japan

    Takahiro Kinoshita

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  1. Yasuhiro Oono
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Correspondence to Yasuhiro Oono.

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Disclosures

Kohei Shitara reports personal fees from Astellas Pharma, grants and personal fees from Lilly, personal fees from Bristol-Myers Squibb, personal fees from Takeda, personal fees from Pfizer, grants and personal fees from Ono Pharmaceutical, personal fees from Novartis, personal fees from Abbvie, personal fees from Yakult, grants from Dainippon Sumitomo Pharma, grants from MSD, grants from Daiichi Sankyo, grants from Taiho Pharmaceutical, grants from Chugai Pharma, outside the submitted work. Takahiro Kinoshita reports personal fees from Olympus, personal fees from Johnson & Johnson, personal fees from Medtronic, personal fees from Yakult Pharma, personal fees from Taiho Pharma, personal fees from Eli Lilly, outside the submitted work. Yasuhiro Oono, Takeshi Kuwata, Kenji Takashima, Yusuke Yoda, Hiroaki Ikematsu, and Tomonori Yano have no conflict of interests or financial ties to disclose.

Ethical approval

The study protocol was approved by the medical ethics committee of the National Cancer Center Hospital East (2017-053). Patient informed consent was waived due to the retrospective design of the study. This study was performed in accordance with the ethical principles outlined in the Declaration of Helsinki.

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Oono, Y., Kuwata, T., Takashima, K. et al. Clinicopathological features and endoscopic findings of HER2-positive gastric cancer. Surg Endosc 32, 3964–3971 (2018). https://doi.org/10.1007/s00464-018-6138-8

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  • DOI: https://doi.org/10.1007/s00464-018-6138-8

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