Evaluation of Human Epidermal Growth Factor Receptor 2 Overexpression, Clinicopathological Characteristics, and Factors Affecting Survival in Gastric Cancer

Objectives: The objective of the study was to evaluate the human epidermal growth factor receptor 2 (HER2) overexpression, clinicopathological features, and factors affecting survival in patients with gastric cancer.
Methods: The study is a retrospective study conducted with 128 cases of gastric cancer who were admitted to Þiþli Hamidiye Etfal Training and Research Hospital between 2005 and 2012. Patients’ demographic characteristics, performance score, tumor localization, information about surgery, HER2 measurements, histopathological characteristics, stage, treatment features, metastasis sites, and overall survival time were obtained from medical records. Immunohistochemical analysis was performed for HER2 scoring.
Results: There were 89 (69.5%) men and 39 (30.5%) women in the study group, and the median age of the patients was 64 years. The median survival time of the patients was 24.43 months. The survival rate of the patients was calculated as 35.4±5.9%. Overall survival time was found to be shorter in the group with higher HER2 levels and also those with advanced-stage cancer. The survival rate was found to be significantly lower in patients with perineural invasion and advanced stage. However, the survival rate was not associated with lymphovascular invasion, surgical margin involvement, and HER2 levels. In the multivariate Cox Regression analysis performed to assess the effects of gender, histological subtype, stage, and surgical margin on overall survival, disease stage was found to be the only factor effective on survival. Gender, histological subtype, and the surgical margin did not affect prognosis.
Conclusion: The survival rate in gastric cancers was found to be lower in those with advanced-stage disease. Higher HER2 level and the disease stage were associated with shorter overall survival time.

Mide kanserinde aþýrý HER2 ekspresyonunun klinikopatolojik özellikleri ve saðkalýmý etkileyen faktörler

Amaç: Mide kanserli hastalarda aþýrý HER2 ekspresyonunun, klinikopatolojik özellikleri ve saðkalýmý etkileyen faktörleri deðerlendirmek.
Yöntemler: Çalýþma, 2005-2012 yýllarý arasýnda hastanemize baþvuran 128 mide kanseri (non-lenfoma histolojik tip) olgusu ile yapýlan retrospektif bir çalýþmadýr. Hastalarýn demografik özellikleri, performans skoru, tümör lokalizasyonu, ameliyat hakkýnda bilgiler, HER2 ölçümleri, histopatolojik özellikleri, evreleri, tedavi özellikleri, metastaz bölgeleri ve genel saðkalým süresi týbbi kayýt sisteminden elde edildi. HER2 skorlamasý için immüno-histokimyasal analiz yapýldý.
Bulgular: Çalýþma grubunda 89 (% 69,5) erkek ve 39 (% 30,5) kadýn vardý ve hastalarýn ortanca yaþý 64 idi. Medyan saðkalým süresi 24,43 aydý. Hastalarýn 5 yýllýk saðkalým oraný % 35.4 ± 5.9 olarak hesaplandý. Genel saðkalým süresinin daha yüksek HER2 seviyeleri olan grupta ve ayrýca ileri evre kanseri olanlarda daha kýsa olduðu bulunmuþtur. Perinöral invazyonlu ve ileri evre hastalarda 5 yýllýk saðkalým oraný anlamlý olarak daha düþük bulundu. Bununla birlikte, 5 yýllýk saðkalým oraný, lenfovasküler invazyon, cerrahi sýnýr tutulumu ve HER2 seviyeleri ile iliþkili deðildi. Cinsiyet, histolojik alt tip, evre ve cerrahi sýnýrýn genel saðkalým üzerindeki etkilerini deðerlendirmek için yapýlan çok deðiþkenli Cox Regresyon analizinde hastalýk evresinin saðkalým üzerinde etkili tek faktör olduðu bulundu. Cinsiyet, histolojik alt tip ve cerrahi sýnýrýn prognoz üzerine etkisi yoktu.
Sonuç: Mide kanserlerinde 5 yýllýk saðkalým oraný ileri evre hastalýðý olanlarda daha düþük bulundu. Daha yüksek HER2 seviyesi ve hastalýk evresi, daha kýsa genel hayatta kalma süresi ile iliþkilendirildi. (SETB-2020-11-241)