The Role of Human Epidermal Growth Factor Receptor (HER2/neu) in the Prognosis of Patients with Gastric Cancer

Document Type : Research Articles


1 Department of Internal Medicine,Kermanshah University of Medical Sciences, Kermanshah, Iran.

2 Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

3 Molecular Pathology Research Center, Imam Reza University Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.

4 Taleghani University Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.

5 Department of Biostatistics, Public Health College, Kermanshah University of Medical Sciences, Kermanshah, Iran.


Objective: Gastric cancer is one of the oncological challenges, and tendency toward target therapy in this cancer
has been increased. Controversy still exists on prognostic value of HER2/neu expression and its relationship with
clinicopathological characteristics and survival of gastric cancer patients. In this regard, the present study examined
the status of HER2/neu in patients with gastric cancer and its prognostic effects. Methods: Pathological samples of 97
gastric cancer patients diagnosed over the last 8 or 9 years (from 2008 to the end of 2017) and treated with 5-fluorouracil,
Docetaxel, and Cisplatin (TCF) were studied in this investigation. Patients were assigned to two groups according to
their HER2/neu status. First group included patients with positive HER2/neu (Score 3) and second group involved
patients with negative HER2/neu (Score 0 and 1). Patients were compared in terms of disease stage, survival rate,
and mortality. Results: The mean age of patients was 58 years old. There were 75 men and 22 women in this study.
In terms of disease stage, 4, 21, 41, and 31 patients were in stage I, II, III, and IV, respectively. Using IHC method,
it was found that 27, 23, 25, and 22 patients had HER2/neu expression with score 0, score +1, score 2+ and score+3,
respectively. We discovered that expression of positive HER2/neu was associated with male sex. We also observed
that survival and mortality rates following treatment initiation were significantly different between HER2/neu positive
and negative gastric cancer patients (P<0.01). Conclusion: Evaluation of HER2/neu status in gastric cancer patients
showed that HER2/neu 3+ expression could reduce the patients’ survival. Therefore, it is recommended that patients
who may benefit from trastuzumab, be treated. A clinical multi-center trial should be also considered for use of this
drug in adjuvant cases.


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