Relative Prognostic Value of Human Epidermal Growth Factor Receptor 2 (HER2)‎ Expression in Operable Oesophagogastric Cancer

Abstract EN

Aims.

The aim of this study was to determine the prognostic significance of HER2 receptor expression in operable oesophagogastric adenocarcinoma.

Methods.

Eighty-five consecutive patients diagnosed with oesophagogastric adenocarcinoma [18 oesophageal (OC), 32 junctional (JC) and 35 gastric (GC)] undergoing potentially curative resection were studied retrospectively.

Immunohistochemistry was used to determine HER2 status at endoscopic biopsy and resection specimen.

The primary outcome measure was survival.

Results.

Twenty (24%) patients had HER2 positive tumours which was commoner in JC (14/32, 44% versus 2/18, 11% in OC and 4/35, 11% in GC, P=0.003).

The sensitivity, specificity, positive and negative predictive values of HER2 status at endoscopic biopsy were 56%, 93%, 63%, 91% respectively (weighted Kappa=0.504, P<0.0001).

Five-year survival in OC HER2 positive negative was 100% and 36% (P=0.167) compared with 14% and 44% (P=0.0726) in JC and 50% and 46% (P=0.942) in GC respectively.

Conclusions.

Endoscopic biopsy had a high specificity and negative predictive value in determining HER2 status.

Patients with JC had a significantly higher rate of HER2 overexpression and this was associated with a nonsignificant poorer survival trend.

A larger study is needed to confirm these findings because of the implications for neoadjuvant and adjuvant chemotherapy regimens.