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. 2014 Sep;2(5):751-755.
doi: 10.3892/mco.2014.329. Epub 2014 Jun 27.

Expression of human epidermal growth factor receptor 2 in primary and paired parenchymal recurrent and/or metastatic sites of gastric cancer

Ryosuke Shibata  1 , Satoshi Nimura  2 , Tatsuya Hashimoto  1 , Toru Miyake  1 , Shinsuke Takeno  1 , Seiichiro Hoshino  1 , Kazuki Nabeshima  2 , Yuichi Yamashita  1
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Expression of human epidermal growth factor receptor 2 in primary and paired parenchymal recurrent and/or metastatic sites of gastric cancer

Ryosuke Shibata et al. Mol Clin Oncol. 2014 Sep.

Abstract

Human epidermal growth factor receptor 2 (HER2) status has been evaluated at the primary site of gastric cancer when planning trastuzumab therapy against recurrent or metastatic lesions, since tissue sampling is uncommon in recurrent or metastatic lesions. This study retrospectively investigated the concordance of HER2 expression between primary and metastatic/recurrent lesions in order to confirm sensitivity to trastuzumab. The subjects comprised 37 patients with gastric adenocarcinoma who underwent tissue biopsy or surgical resection of the primary sites and 49 paired synchronous or metachronous metastatic sites (excluding lymph nodes) at the Fukuoka University Hospital between January, 1998 and September, 2012. All the samples were evaluated for HER2 status at the invasive front by immunohistochemistry (IHC). The HER2 positivity rate of the primary sites was ~16% and the concordance ratio of the IHC results between primary and paired metastatic sites was ~97%. No discordant cases regarding HER2 status were found among metachronous interventions for metastatic lesions. Only one patient exhibited conversion from a HER2-negative status in all the portions of the primary site to a positive status in a metastatic site. In conclusion, a high concordance ratio for HER2 status was observed between primary and paired metastatic lesions. Thus, employing trastuzumab therapy against metastatic or recurrent gastric cancer based on the HER2 status of the primary lesion appears to be an acceptable approach.

Keywords: concordance; human epidermal growth factor receptor 2; inoperable gastric cancer; multiple intervention.

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Figures

Figure 1
Figure 1
Human epidermal growth factor receptor 2 (HER2) expression by immunohistochemistry (A) at the primary site and (B) at paired metastatic sites. The histological type at the primary site was moderately differentiated tubular adenocarcinoma and HER2 status was scored as 0. The metastatic site was the liver and HER2 status was scored as 3+. Magnification, ×40.
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