Frequency of HER2/neu Overexpression in Gastrointestinal Adenocarcinomas

An Immunohistochemical Study in A Tertiary Care Hospital

  • Gayathri Devi Parasa GSL Medical college, Rajamahendravaram- Andhra Pradesh, India
  • Ruth Prasanna Mark GSL Medical college, Rajamahendravaram- Andhra Pradesh, India
Keywords: HER2 expression, immunohistochemistry, gastric, colorectal, adenocarcinomas


Background: As per the data available in the literature, a wide range of HER2neu protein expression in gastric and colorectal adenocarcinomas was reported in various studies world wide. Even though HER2neu over expression has a poor prognosis in these tumours, there is an increased demand for HER2neu study in the laboratories because of the availability of targeted therapy like Transtuzumab. Aim of the study was to determine the frequency of HER2neu protein overexpression in gastrointestinal adenocarcinomas. We studied innunohistochemical expression of HER2neu in a total of 71 cases of gastrointestinal adenocarcinomas. Methods: This was a prospective study done on 71 cases of gastrointestinal adenocarcinomas diagnosed in the pathology laboratory of a tertiary care hospital. Both small biopsies and resection specimens were included. Paraffin blocks and hematoxylin eosin stained sections of these cases were retrieved from the files. Sections were cut from the paraffin blocks and immunohistochemical staining for HER2/neu done. HER2/neu stained sections were examined and findings noted according to the guidelines for HER2neu reporting of gastric biopsies. Result: HER2/neu positivity (3+ score) on immunohistochemistry was seen in 8 out of 71 gastrointestinal adenocarcinomas (11.26%). HER2 positivity was 9.52% (4 out of 42 cases) in gastric adenocarcinomas and 10.2% (4 out of 39 cases) of colorectal adenocarcinomas. Conclusion: HER2 positivity was seen in a significant number of gastrointestinal adenocarcinomas tested, i.e. 9.52% of gastric adenocarcinomas and 10.2% of colorectal adenocarcinomas. Overall positivity in gastrointestinal carcinomas was 11.26%. Positivity was seen in cases reported on small biopsies. We did not attempt to study the correlation between HER2 positivity with clinicopathological findings because of the small number of cases studied.

Author Biographies

Gayathri Devi Parasa, GSL Medical college, Rajamahendravaram- Andhra Pradesh, India
Dept of Pathology
Ruth Prasanna Mark, GSL Medical college, Rajamahendravaram- Andhra Pradesh, India
Dept of Pathology


1. Schuell B, Gruenberger T, Scheithauer W, Zielinski Ch, Wrba F. HER 2/neu protein expression in colorectal cancer. BMC Cancer 2006;6:123-127.
2. Van CE, Kang Y, Chung H, Shen L, Sawaki A, Lordick F, et al.Efficacy results from the ToGA trial: A phase III study of trastuzumab added to standard chemotherapy (CT) in first-line human epidermal growth factor receptor 2 (HER2)-positive advanced gastric cancer (GC) J Clin Oncol. 2009;27:15s. (supple;abstr LBA4509)
3. Bang YJ, Van CE, Feyereislova A, Chung HC, Shen L, Sawaki A, et al. Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric and gastroesophageal junction cancer (ToGA): a phase 3, open-label, randomized control trial. Lancet. 2010;376:687–97
4. Ruschoff J, Hanna W, Bilous M et al. HER2 testing in gastric cancer: a practical approach. Mod Pathol 2012; 25: 637–50
5. Hofmann M, Stoss O, Shi D, Buttner R, Vijver MVD, Kim W, et al. Assessment of HER2 scoring system for gastric cancer: results from a validation study. Histopathology. 2008;52:797–805
6. Shan L, Ying J, Lu N. HER2 expression and relevant clinicopathological features in gastric and gastroesophageal junction adenocarcinoma in a Chinese population. Diagn Pathol 2013; 8: 76–82
7. Ingold HB, Behrens HM, Balschun K, Haag J, Kruger S, Becker T, et al. HER2/neu testing in primary colorectal carcinoma. Br J Cancer 2014;111:1977-84
8. Sekaran A, Kandagaddala RS, Darisetty S, Lakhtakia S, Ayyagari S, Rao GV, et al. HER2 expression in gastric cancer in Indian population-an immunohistochemistry and fluorescence in situ hybridization study. Indian J Gastroenterol. 2012;31(3):106
9. Aditi R, Aarathi R, Pradeep R, Hemalatha L, Akshatha C, Amar K. HER2 Expression in Gastric Adenocarcinoma-a study in a tertiary care centre in South India. Indian J Surg Oncol 2016;7:18-24
10. Farzand S, Siddique T, Saba K, Bukhari MH. Frequency of HER2/neu overexpression in adenocarcinoma of the gastrointestinal system. World Journal of Gastroenterology : WJG. 2014;20(19):5889-5896
11. Rajagopal I, Niveditha SR, Sahadev R et al. HER 2 Expression in gastric and gastro-esophageal junction (GEJ) adenocarcinomas. J Clin Diagn Res 2015; 9: EC06–10
12. Pathmathan N, Geng J, Li W, Nie X, Veloso J, Wang J et al. Human epidermal growth factor receptor 2 status of gastric cancer patients in Asia: results from a large, multicountry study. Asia-Pac J Clin Oncol 2017; 13: 249–260
13. Chao H, Xue-Yi B, Xing-Zhi N, Shen DP, Shen YY, Liu H, et al. Correlation of human epidermal growth factor receptor 2 expression with clinicopathological characteristics and prognosis in gastric cancer. World J Gastroenterol. 2013;19:2171–78
14. Tafe LJ, Janjigian YY, Zaidinski M, Hedvat CV, Hameed MR, Tang LH, et al. Human epidermal growth factor receptor 2 testing in gastresophageal cancer: correlation between immunohistochemistry and fluorescence in situ hybridization. Archives of pathology & laboratory medicine. 2011;135:1460–65
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