Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Original article / research
Table of Contents - Year : 2017 | Month : October | Volume : 11 | Issue : 10 | Page : EC01 - EC05

HER2 and Helicobacter pylori Status in Resected Gastric Cancers: A Pathological Study of a Gastroenterological Issue EC01-EC05

Saraswathy Sreeram, Shrijeet Chakraborti, Ramdas Naik, Debarshi Saha, Yeshwanter Radhakrishnan, Hanaganahalli Basavaiah Sridevi, Sharada Rai, Chaithra Gowthuvalli Venkataramana

Dr. Shrijeet Chakraborti,
Associate Professor, Department of Pathology, Kasturba Medical College,
Lighthouse Hill Road, Hampankatta, Mangaluru-575001, Karnataka, India.

Introduction: Human epidermal growth factor receptor 2 (HER2)/neu is a critical target for gastric carcinoma treatment utilizing trastuzumab. Helicobacter pylori is a well known causative agent of gastric carcinoma.

Aim: To study association of HER2/neu expression with the presence of H. pylori infection in resected carcinoma stomach patients.

Materials and Methods: A cross-sectional study of 85 gastrectomies received in the department from January 2010 to September 2014 was done. HER2/neu was studied using Immunohistochemistry (IHC) and Giemsa stain was used to detect presence of H. pylori. Chi-square test and Fisher’s exact test were used, to test the correlation between the various parameters. A p-value <0.05 was considered significant.

Results: Our study population included 67 (78.8%) males, and 18 (21.2%) females, ranging from 22 to 84 years, mean 57.68±12.12 years. HER-2 expression, graded from 0 to 3± was correlated with location, histologic type, grade, local invasion, metastasis to lymph nodes, TNM tumour staging and H. pylori infection, graded from 0 to 3+ using Giemsa stain. HER2/neu 3+ was observed in intestinal type of gastric cancer (5/55, 9%) only. Scores 2+ and 3+ were more common in H. pylori-negative patients (5/26, 19.2%) than H. pylori-positive patients (4/59, 6.8%) (p=0.02). TNM stage, extent of local invasion and lymph node metastasis in intestinal gastric carcinomas correlated significantly with HER2/neu expression. H. pylori was present in 59 (69.4%) and absent in 26 (30.6%).

Conclusion: H. pylori-negative gastric cancer showed significant immunophenotypic HER2/neu overexpression i.e., H. pylori might protect against HER2 overexpression that correlated significantly with higher TNM stages of intestinal-type gastric cancer. In contrast, H. pylori infection correlated significantly with Lymph-Vascular Invasion (LVI) but was pN1/2+, thereby diminishing prognostic importance. H. pylori induced intestinal metaplasia was not significantly associated with intestinal-type gastric cancer.