Study of prognostic indicators and Her2neu expression in gastric adenocarcinomas – A tertiary care centre study

Abstract

Gastric carcinomas rank 5th among all the cancers in India. The incidence increases with age and peaks during 5th to 7th decades. The most common location is gastric antrum followed by the lesser curvature. Her2 neu expression is reported as a frequent molecular abnormality in gastric adenocarcinomas associated with poor prognosis. The main aim was to study clinicopathological parameters of gastric carcinomas and study expression of HER2 in gastric adenocarcinomas. This was a 4-year cross-sectional observational retrospective and prospective study of 47 cases of gastric carcinomas. The clinical profile and pathological features were studied. HER2 expression in gastric adenocarcinomas was scored according to Hoffman system and its association with age, gender, histopathological type, grade was studied. FISH was done in cases of equivocal HER2/Neu expression.Of the total 47 gastric carcinomas, it was most commonly found in antrum. Mean age of presentation was 59.4 years with male: female ratio of 1.4:1. Of total 47 adenocarcinomas, 22 were tubular, 4 cases each of papillary and mixed adenocarcinoma and 17 were poorly cohesive carcinoma. There were 5 cases of grade I, 27 grade II and 15 grade III carcinomas. HER2 positivity was seen in 10 cases, 5 were equivocal and 32 were HER2 negative. We found statistically significant correlation between HER2 expression with histopathological grade (P=0.003) and age (P=0.014).Tubular adenocarcinoma was the common subtype and antrum was the commonest location. HER2 expression was significantly associated with grades and age in cases of gastric adenocarcinomas. This study helped us to know the trends of gastric carcinoma in our region. Use of immunohistochemistry and fluorescent in situ hybridization techniques additionally supports the use of targeted therapeutic modalities.