Clinicopathological Evaluation and HER2 Expression in Gastric Adenocarcinomas: A Hospital Based Observational study

Vinodhini, R (2020) Clinicopathological Evaluation and HER2 Expression in Gastric Adenocarcinomas: A Hospital Based Observational study. Masters thesis, Trichy SRM Medical College Hospital and Research Centre, Trichy.


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INTRODUCTION: Worldwide statistics shows that the gastric carcinoma is the third most common cancer diagnosed and also cause for cancer related death worldwide. The treatment of choice in patients with early-stage of both carcinomas is surgical resection which has a good cure rate and five-year survival rate calculated to be 80-95%. But in patients with advanced gastric or gastro esophageal junction cancers, even with chemotherapy given preoperatively or adjuvant chemo radiation, the five year survival rate of patients remains very poor being less than 30%. In this new era, trastuzumab, a type of monoclonal antibody interferes with HER2/neu receptor function has shown to improve or increase the survival of patients with advanced gastric cancer. AIM OF THE STUDY: 1. To determine clinico pathological correlation of gastro-oesophageal junction and gastric adenocarcinomas. 2. To grade gastro-oesophageal junction and gastric adenocarcinomas histopathologically using world health organization grading system. 3. To determine the frequency of overexpression of HER2 in selected cases. MATERIALS AND METHODS: TYPE OF STUDY: Observational study. PLACE OF STUDY: Department of Pathology, TSRMMCH & RC, Trichy. STUDY DESIGN: Descriptive (Prospective) study. INCLUSION CRITERIA: ◈ All histopathologically diagnosed adenocarcinoma cases of gastric and gastro-oesophageal junction irrespective of age, sex and residence were included in this study. ◈ Patients who are willing to give consent for the study. EXCLUSION CRITERIA: The following tumours were excluded from this study: Carcinomas other than gastric adenocarcinomas. ◈ Metastatic tumour to the stomach from another organ ◈ Carcinoid tumours of stomach. ◈ Non-epithelial tumours of stomach. ◈ All biopsy specimens which are inadequate / not properly fixed. Sixty cases of gastric adenocarcinoma including those of the gastro-esophageal junction reported during the study period (November 2017 to June 2019) wastaken up for this study. Clinico-pathological correlation of these 60 cases was done and the overexpression of HER2 in selected samples was studied. RESULTS: Gastric adenocarcinoma had a peak incidence in the age group, 58.95 ± 10.77, predominantly in males (73.3%). Majority of patients [78.3%] were obese, A +ve blood group consuming non-vegetarian diet and were daily wage workers (agricultural laborers and Coolie workers). Most of the patients had presented with epigastric pain (EP), post cibal vomiting (PCV), loss of weight (LOW) and loss of appetite (LOA). Antropyloric region (70.04%) was the most commonly affected site of malignancy and 41% were graded as moderately differentiated adenocarcinomas. Immunohistochemistry profiling using HER2 was done in 12 cases (20%) and HER-2/Neu over expression was seen in one third of cases in which marker study was done. CONCLUSION: To conclude identifying the overexpression of HER-2/Neu in gastric adenocarcinomas helps to narrow down the most eligible candidates for targeted therapy with monoclonal antibody against Her2 neu. The targeting and silencing of this protein, which instigates aggressive biological behavior and higher frequencies of recurrence in HER2 positive tumors may pave way for better prognosis and survival in gastric epithelial malignancies.

Item Type: Thesis (Masters)
Additional Information: 201713602
Uncontrolled Keywords: Gastric / GEJ adenocarcinoma, HER2/ neu, Immunohistochemistry (IHC).
Subjects: MEDICAL > Pathology
Depositing User: Subramani R
Date Deposited: 29 Jan 2021 18:50
Last Modified: 29 Jan 2021 18:50

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