HER2 Status in Premalignant, Early, and Advanced Neoplastic Lesions of the Stomach.
OBJECTIVE
HER2 expression in gastric cancer (GC) has received attention as a potential target for therapy with Trastuzumab. We reviewed the current knowledge on HER2 status in premalignant gastric lesions and in early (EGC) and advanced (AGC) GC to discuss the possible pathogenetic and prognostic roles of HER2 overexpression in GC.


RESULTS
HER2 overexpression was documented in gastric low-grade (LG) and high-grade intraepithelial neoplasia (HG-IEN), with higher frequency in gastric type dysplasia. HER2 overexpression was significantly associated with disease recurrence and poor prognosis in EGC representing an independent risk factor for lymph node metastases. HER2 overexpression was more frequent in AGC characterized by high grade, advanced stage, and high Ki-67 labeling index. The discordance in HER2 status was evidenced between primitive GC and synchronous or metachronous metastases.


CONCLUSIONS
HER2 overexpression in premalignant gastric lesions suggests its potential involvement in the early steps of gastric carcinogenesis. The assessment of HER2 status in EGC may be helpful for the identification of patients who are at low risk for developing nodal metastases. Finally, the possible discordance in HER2 status between primary GC and its synchronous metastases support routine assessment of HER2 both in the primary GC and in its metastatic lesions.
Department of Human Pathology "Gaetano Barresi", Section of Anatomic Pathology, Azienda Ospedaliera Universitaria "Gaetano Martino, University of Messina," Via Consolare Valeria 1, 98125 Messina, Italy.
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Ieni
Department of Human Pathology "Gaetano Barresi", Section of Anatomic Pathology, Azienda Ospedaliera Universitaria "Gaetano Martino, University of Messina," Via Consolare Valeria 1, 98125 Messina, Italy.
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Barresi
Department of Pediatrics, Gynecology and Microbiology Sciences, Azienda Ospedaliera Universitaria "Gaetano Martino, University of Messina," Via Consolare Valeria 1, 98125 Messina, Italy.
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Rigoli
Department of Human Pathology "Gaetano Barresi", Section of Anatomic Pathology, Azienda Ospedaliera Universitaria "Gaetano Martino, University of Messina," Via Consolare Valeria 1, 98125 Messina, Italy.
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Caruso
Department of Human Pathology "Gaetano Barresi", Section of Anatomic Pathology, Azienda Ospedaliera Universitaria "Gaetano Martino, University of Messina," Via Consolare Valeria 1, 98125 Messina, Italy.
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Tuccari
D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism*; D006801:Humans; D008207:Lymphatic Metastasis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000235:genetics / Q000378:metabolism*; D013274:Stomach Neoplasms / Q000378:metabolism* / Q000473:pathology
D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases; C508053:ERBB2 protein, human