Clinicopathological features and prognostic significance of HER2 expression in gastric cancer.
BACKGROUND
HER2 positivity is reported to be <20% in gastric cancer. Clinicopathological characteristics will be helpful to understand the biological features of HER2-positive gastric cancer.


METHODS
A total of 813 gastric cancer patients who underwent HER2 testing between January 2005 and December 2010 were included in this study.


RESULTS
Ninety-five (11.7%) patients had HER2-positive gastric cancer. Elevated serum carcinoembryonic antigen (CEA) concentration [odds ratio (OR), 5.629; p < 0.001] and differentiated histology (OR, 3.717; p = 0.002) were significant predictive factors for HER2 positivity in localized disease. For recurrent or metastatic disease, elevated serum CEA concentration (OR, 2.545; p < 0.001), differentiated histology (OR, 3.299; p < 0.001), pulmonary metastasis (OR, 3.321; p = 0.001), and distant lymph node metastasis (OR, 2.286; p = 0.002) were significant predictive factors. Median disease-free survival (DFS) was shorter in HER2-positive patients than in others, especially in stage I or II disease (24.7 vs. 49.2 months; p < 0.001). Among HER2-negative patients with stage II diseases, patients who received adjuvant chemotherapy had longer DFS than others (42.2 vs. 30.7 months; p = 0.025).


CONCLUSIONS
Clinicopathological factors may be useful in predicting the HER2 positivity of gastric cancer. Further studies are needed to understand the molecular basis of HER2-positive gastric cancer.
Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
Ji Soo
JS
Park
Sun Young
SY
Rha
Hyun Cheol
HC
Chung
Minkyu
M
Jung
Ki Hyang
KH
Kim
Hyun Jung
HJ
Jun
Hyunki
H
Kim
Ji Yeong
JY
An
Hyoung-Il
HI
Kim
Jae-Ho
JH
Cheong
Woo Jin
WJ
Hyung
Sung Hoon
SH
Noh
Hyo Song
HS
Kim
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002272:Carcinoembryonic Antigen / Q000097:blood; D018572:Disease-Free Survival; D006801:Humans; D008207:Lymphatic Metastasis / Q000235:genetics / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000235:genetics / Q000473:pathology; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000235:genetics* / Q000378:metabolism*; D013274:Stomach Neoplasms / Q000235:genetics / Q000378:metabolism / Q000473:pathology*; D055815:Young Adult
D002272:Carcinoembryonic Antigen; D018719:Erb-b2 Receptor Tyrosine Kinases; C508053:ERBB2 protein, human