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Cellular Oncology
Volume 32 (2010), Issue 1-2, Pages 57-65
http://dx.doi.org/10.3233/CLO-2009-0497

HER2 Expression in Gastric Cancer: Rare, Heterogeneous and of No Prognostic Value – Conclusions from 924 Cases of Two Independent Series

Heike Grabsch,1 Shivan Sivakumar,1 Sally Gray,2 Helmut E. Gabbert,3 and Wolfram Müller4

1Pathology & Tumour Biology, Leeds Institute of Molecular Medicine, University of Leeds, Leeds, UK
2Department of Histopathology and Molecular Pathology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
3Institute of Pathology, University of Düsseldorf, Düsseldorf, Germany
4Gemeinschaftspraxis Pathologie, Starnberg, Germany

Copyright © 2010 Hindawi Publishing Corporation and the authors. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Patients with gastric cancer (GC) have a poor survival and biologicals such as Trastuzumab have not been used routinely in these patients. Existing data on HER2 expression and its clinical relevance in GC are still limited and controversial.

Methods: HER2 expression was investigated by immunohistochemistry in 418 GC from Germany and 506 GC from England. Results were compared to clinicopathological parameters and patient survival.

Results: Less than 10% of all GC showed HER2 expression in more than 5% of tumour cells and 91% of these were intestinal type GC. In both series, no relationship was found between HER2 expression, patient survival or TNM stage. Marked intratumoural heterogeneity was noted.

Conclusions: This is the largest study to date demonstrating in two independent series that HER2 expression is not related to gastric cancer patient prognosis and that only a very small subgroup of intestinal type GC may potentially respond to HER2 targeting therapy. Due to prominent intratumoural heterogeneity of HER2 expression in GC, HER2 testing in endoscopic biopsies before treatment will be prone to false negative results.