Significance of HER2/neu Expression in Oesophageal Carcinomas and its Association with the Histopathological Grading

Abstract

Introduction: Oesophageal carcinomas are one of the most aggressive human malignancies which are associated with a poor prognosis because most of the cases are in stage 2 or 3 at the time of diagnosis with a high frequency of lymph node metastases. It is important to know the prognostic factors can help us on therapeutic decisions and improve the survival of these patients. A member of Epidermal Growth Factor Receptor (EGFR) family, Human Epidermal Growth Factor Receptor 2 (HER-2/neu) is a very useful antigenic marker expressed in oesophageal carcinomas which has increasing evidence of therapeutic significance. Aim: To determine the immunological expression of HER2/ neu in oesophageal carcinomas and associate it with the histopathological grading. Materials and Methods: This cross-sectional study was conducted in Department of Pathology at Coimbatore Medical College, Coimbatore, Tamil Nadu, India, from January 2015 to February 2016. Total 30 cases of histologically proven oesophageal carcinomas were subjected for HER2/neu immunoexpression. Membranous staining was considered as positive and the intensity of staining was scored and compared with various histopathological parameters. The p-value<0.05 using a two-tailed test was taken as level of significance for all statistical tests. Results: Among 30 cases, 24 were squamous cell carcinomas and six were adenocarcinomas. Out of 24 cases of squamous cell carcinomas, there were 20 males and four females. All the six adenocarcinoma cases were males. HER2/neu was positive in 10 cases(41.6%) of squamous cell carcinoma and 4 cases(66.6%) of adenocarcinoma. It was seen in 10% of well differentiated, 60% of moderately differentiated and 80% of poorly differentiated carcinomas. There was significant correlation with staging and lymph node metastases. Higher grade tumours had higher level of expression of HER2/neu. Conclusion: The HER2/neu immunoexpression was significantly higher with progression of tumour grade. Hence, such patients with high grade oesophageal carcinomas and with lymph node metastases could be benefitted with targeted therapy