STUDY OF HER2/NEU AND Ki-67 EXPRESSION IN GASTRIC AND ESOPHAGOGASTRIC JUNCTION ADENOCARCINOMA AND THEIR CORRELATION WITH GRADE AND STAGE

Dr. Piyali Pramanik, Dr. Ranu Sarkar, Dr. Moumita Maity

Abstract


INTRODUCTION: Gastric cancer is one of the most aggressive malignancies with an extremely poor prognosis.  It accounts for 5.7% of cancer worldwide with a mortality rate of 8.2%. Surgical resection is the mainstay of therapy for gastric and esophago-gastric junction( EGJ )carcinomas followed by chemotherapy. However, most patients are diagnosed in an unresectable stage with decrease in survival rates. New therapeutic strategies like targeted therapy may help to improve prognosis. Patients with  HER2/neu overexpression benefit from transtuzumab therapy. It is therefore essential to determine the HER2/neu status of tumors.

OBJECTIVE OF RESEARCH: To study the expression of HER2/neu and Ki67 index  in histologically diagnosed cases of gastric and EGJ adenocarcinoma and their clinicopathological correlation.

METHODOLOGY :A prospective, observational, non- interventional study was done in the Department of Pathology in collaboration with Department of General Surgery,NRS Medical college, Kolkata in a duration between 1st January 2018 to 30th June 2019.All the total and partial gastrectomy specimen& specimen of endoscopic biopsy were processed in the Department of Pathology for Histopathological examination and IHC study.

RESULTS: Among 52 cases of gastric and EGJ adenocarcinoma, majority were males (69.2%)  and antrum (63.5%) being  the most common site. HER2 expression was observed in 23.0% of cases and statistically significant correlation was found with intestinal type (p<0.0001), tumour grade ( p= 0.0152) and location of the tumor ( p= 0.028). High Ki-67 index was observed in 67.3% of gastric and EGJ adenocarcinoma having significant correlation with tumor grade (p<0.0001)and stage(p<0.001).

CONCLUSION: Intestinal-type and moderately differentiated gastric cancers predominantly showed HER2 neu positivity and also high Ki67 proliferation index. So, these patients may be considered for targeted therapy using Trastuzumab in combination with chemotherapy


Keywords


gastric and EGJ adenocarcinoma, HER2/neu, Ki67

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