Tumor Characteristics Associated with Lymph Node Metastasis and Prognosis in Patients with ERBB2-Positive Gastric Cancer

Abstract

Gastric cancers (GCs) that express human erb-b2 receptor tyrosine kinase 2 (ERBB2, also known as HER2) account for 7.3%–20.2% of GCs. The pathological and prognostic factors associated with lymph node metastasis of such tumors are still unclear. Therefore, we aimed to identify the risk factors for lymph node metastasis and prognostic factors of patients with ERBB2-positive GC. We conducted a retrospective analysis of pathological specimens after D2 radical surgery for locally advanced GC and D1+ surgery performed for early GC in our hospital from January 2015 to December 2018. Patients with ERBB2-positive GC were selected and the potential risk factors for lymph node metastasis and potential factors affecting prognosis were evaluated. Among 1,124 GC patients, 122 diagnosed with ERBB2-positive GC were included in the study. We found that risk factors for lymph node metastasis included tumor size (hazard ratio (HR)- 6.213, 95% confidence interval (CI)- 2.097–18.407, $p=0.001$ ), neural invasion (HR- 2.876, 95% CI - 1.011–8.184, $p=0.048$ ), and vascular invasion (HR- 16.881, 95% CI - 5.207–54.727, $p<0.001$ ). T stage (HR- 4.615, 95% CI - 2.182–9.759, $p<0.001$ ) and vascular invasion (HR- 3.036, 95% CI - 1.369–6.736, $p=0.006$ ) were significant prognostic variables. These findings shed new light on the pathology and prognosis of patients with ERBB2-positive GC.