Table of Contents
ISRN Surgery
Volume 2012 (2012), Article ID 804891, 6 pages
http://dx.doi.org/10.5402/2012/804891
Clinical Study

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

1Department of Surgery, University Hospital of Wales, Heath Park, Cardiff, CF14 4XN, UK
2Department of Cellular Pathology, University Hospital of Wales, Heath Park, Cardiff CF14 4XN, UK
3Department of Surgery, Nevill Hall Hospital, Abergavenny NP7 7EG, UK
4Institute of Cancer and Genetics, Cardiff University School of Medicine, Cardiff CF14 4XW, UK

Received 5 April 2012; Accepted 14 June 2012

Academic Editors: D. M. D'Ugo and G. A. Tiberio

Copyright © 2012 David S. Y. Chan et al. 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

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 . 0 0 3 ). The sensitivity, specificity, positive and negative predictive values of HER2 status at endoscopic biopsy were 56%, 93%, 63%, 91% respectively (weighted K a p p a = 0 . 5 0 4 , 𝑃 < 0 . 0 0 0 1 ). Five-year survival in OC HER2 positive negative was 100% and 36% ( 𝑃 = 0 . 1 6 7 ) compared with 14% and 44% ( 𝑃 = 0 . 0 7 2 6 ) in JC and 50% and 46% ( 𝑃 = 0 . 9 4 2 ) 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.