title: Association of HER2/ErbB2 expression and gene amplification with pathologic features and prognosis in esophageal adenocarcinomas.
abstract: OBJECTIVE
  We examined the frequency, tumor characteristics, and prognostic impact of HER2 protein expression and gene amplification in patients with curatively resected esophageal adenocarcinoma (EAC).
  
  
  METHODS
  HER2 expression was analyzed by immunohistochemistry (IHC) in surgical EAC specimens (n = 713). Gene amplification was examined by FISH in a large subset (n = 344). Most tumors were T3-4 (66%) or node positive (72%); 95% were located in the esophagus or gastroesophageal junction. No patient received neoadjuvant therapy. Cox models were used.
  
  
  RESULTS
  Overall, 17% of EACs were HER2 positive (i.e., IHC3(+) or IHC2(+) with amplification), with strong agreement between HER2 amplification (HER2/CEP17 ratio ≥2) and expression (κ = 0.83). HER2 positivity was significantly associated with lower tumor grade, less invasiveness, fewer malignant nodes, and the presence of adjacent Barrett's esophagus (BE). EACs with BE had higher odds of HER2 positivity than EACs without BE, independent of pathologic features [OR = 1.8 (95% CI: 1.1-2.8), P = 0.014]. Among all cases, HER2 positivity was significantly associated with disease-specific survival (DSS) in a manner that differed by the presence or absence of BE (P(interaction) = 0.0047). In EACs with BE, HER2 positivity was significantly associated with improved DSS [HR = 0.54 (95% CI: 0.35-0.84), P = 0.0065] and overall survival (P = 0.0022) independent of pathologic features, but was not prognostic among EACs without BE.
  
  
  CONCLUSIONS
  HER2 positivity was shown in 17% of resected EACs and associated with reduced tumor aggressiveness. EACs with BE had nearly twice the odds of being HER2 positive and, within this subgroup, HER2 positivity was independently associated with improved survival.
authors.affiliation: Departments of Medical Oncology, Health Sciences Research, Cytogenetics, Anatomic Pathology, Cancer Center, Laboratory Medicine and Pathology, and Gastroenterology, Mayo Clinic, Rochester, MN 55905, USA. yoon.harry@mayo.edu
authors.forename: Harry H
authors.initials: HH
authors.lastname: Yoon
authors.forename: Qian
authors.initials: Q
authors.lastname: Shi
authors.forename: William R
authors.initials: WR
authors.lastname: Sukov
authors.forename: Anne E
authors.initials: AE
authors.lastname: Wiktor
authors.forename: Maliha
authors.initials: M
authors.lastname: Khan
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Sattler
authors.forename: Axel
authors.initials: A
authors.lastname: Grothey
authors.forename: Tsung-Teh
authors.initials: TT
authors.lastname: Wu
authors.forename: Robert B
authors.initials: RB
authors.lastname: Diasio
authors.forename: Robert B
authors.initials: RB
authors.lastname: Jenkins
authors.forename: Frank A
authors.initials: FA
authors.lastname: Sinicrope
mesh_terms: D000230:Adenocarcinoma / Q000235:genetics / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D001471:Barrett Esophagus / Q000235:genetics / Q000378:metabolism / Q000401:mortality / Q000473:pathology; D015331:Cohort Studies; D004938:Esophageal Neoplasms / Q000235:genetics / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D005260:Female; D005784:Gene Amplification; D018628:Gene Dosage; D015870:Gene Expression; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D011230:Precancerous Conditions / Q000235:genetics / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000235:genetics / Q000378:metabolism*; D012307:Risk Factors
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; C508053:ERBB2 protein, human