Query: ki-67 and her 2 neu in gastric carcinoma

title: Serum Level of HER 2/neu in Patients with Gastric Cancer: Correlation with HER 2/neu Overexpression in Gastric Carcinoma Tissue
abstract: Serum HER 2/neu (c erbB 2) levels in patients with gastric cancer were evaluated by an enzyme linked immunosorbent assay and tissue levels of HER 2/neu in the same cohort were determined by immunohistochemistry. Nine (16% of 57 gastric carcinomas had an overexpression of HER 2/neu detected immunohistochemically. Of these 9 patients, 6 had elevated serum HER 2/neu levels, while 45 of 48 tissue samples with negative staining exhibited normal serum HER 2/neu levels. These results indicated that overall accuracy, positive predictive value, and negative predictive values of their serum measurements were 89, 67 and 94% respectively. Serum levels of HER 2/neu were correlated with tissue overexpression of HER 2/neu in patients with gastric cancer.

title: HER2 status in advanced gastric carcinoma: A retrospective multicentric analysis from Sicily
abstract: According to the ToGA trial, HER2 has been shown to be predictive for the success of treatment with trastuzumab in advanced gastric cancer (AGC) A number of studies have analyzed HER 2/neu overexpression in gastric carcinoma and identified the rate of HER2 positivity to be markedly varied. To date, the prevalence of HER2 overexpression in Sicilian people with AGC is unknown. Therefore, in the present study, a retrospective immunohistochemical analysis of HER2 was performed in a cohort of 304 AGC samples that were obtained from the archives of 10 Sicilian anatomopathological diagnostic units in order to verify the positive rate of HER2 positive cases. Furthermore, the characteristics of histotype, grade, stage and Ki 67 expression were also analyzed. HER2 overexpression was encountered in 17.43% of all the gastric adenocarcinomas, which was consistent with the results that have been reported elsewhere in the literature. A progressive increase in HER2 overexpression was observed, from the poorly cohesive histotype to the tubular adenocarcinomas and gastric hepatoid adenocarcinomas. HER2 overexpression was significantly associated with a high grade, advanced stage and high Ki 67 labeling index. Further investigations performed jointly by pathologists and oncologists within the geographical area of the present study should confirm that the association of trastuzumab with chemotherapy results in an improvement of survival in patients with AGC.

title: HER 2/Neu Status in Gastric Carcinomas in a Series of Egyptian Patients and Its Relation to Ki 67 Expression
abstract: HER 2/neu status in gastric carcinomas (GCs) has not been studied before in the Egyptian population.  Seventy three GCs were evaluated for the expression of HER 2/neu and Ki 67 using immunohistochemistry (IHC) Fluorescence in situ Hybridization (FISH) was done for HER2/neu IHC score 2+ cases.  Out of the 73 gastric carcinomas, 23 (31.5% were score 0, 17 (23.3% were score 1+ 23 (31.5% were score 2+ and 10 (13.7% were score 3+ FISH analysis revealed that the HER 2/neu gene was amplified in 11 out of the 23 cases (47.8% scored 2+ by IHC. Therefore, the overall HER 2/neu positivity rate was 28.8% and it was significantly associated with higher T stage and lymphovascular invasion (LVI) The Ki 67 expression rate ranged between 10% and 100% with 84.9% of the cases (n 62) featuring high Ki 67 scores. High Ki 67 score was significantly associated with male sex, tumor grade, and number of positive nodes. HER 2/neu protein expression correlated significantly with Ki 67 score. Twenty tumors showed combined HER 2/neu positivity and high Ki 67 score and were significantly associated with higher T stage and occurrence of LVI, implying a more aggressive behavior.  The rate of HER 2/neu positive GCs in our series simulates universal rates, thereby mandating routine evaluation of HER 2/neu status in all GCs submitted to our laboratory to benefit from trastuzumab therapy. Further studies on a larger number of GCs are required to prove that the concurrent HER 2/neu positivity and high Ki 67 score are markers of worse prognosis.

title: Role of Her 2 Neu in Gastric Carcinoma 3 Year Study in a Medical College Hospital
abstract: rd most common cause of mortality of all cancers in both sexes. It constitutes 8.5% of all cancers with 73.5% of all gastric cancers occurring in Asian countries.The crude and age standardised rate are 12.2 and 11.4/1,00,000 population world wide and in India it is 5.0 and 6.1/ 1,00,000 population respectively. 1 Gastric adenocarcinoma has a dismal prognosis with a median survival of few months in advanced cases 2 There is a constant search for newer modalities of treatment in gastric cancer to improve the survival. A recent phase III trial (ToGA trial) in which trastuzumab with chemotherapy was given in Her 2 positive cancers there was improvement in overall survival in locally advanced, recurrent and metastatic gastric cancer when compared to chemotherapy alone.2 Her 2 /neu is a transmembranetyrosinekinase receptor which is a member of the growth factor receptor family and targeted therapy by monoclonal antibody was found effective in neoadjuvant, adjuvant and palliative setting in breast cancer in various randomized controlled trials. As in breast cancer wherein 30% of cases have Her 2/neu positivity the incidence of Her2 positivity in gastric cancer varied in different studies based on stage of cancer, location of tumor and geographic area where it was studied. 3

title: Expression and clinical significance of HER 2/neu in gastric carcinoma
abstract: To investigate the expression of epidermal growth factor receptor(HER) 2/neu in gastric cancer,and its clinicopathologic significance.(Methods) The expressions of HER 2/neu in 67 gastric carcinomas were detected by immunohistochemistry and analyze the relationship of the expression to clinicopathologic data of the patients.(Results) The positive expression of HER 2/neu were detected in 15 of 67 gastric cancer specimens(22.4%,but not in adjacent normal tissue.The expression of HER 2/neu was not correlated to sex,age and histological grades of patients(P0.05),but to the lauren's classification,lymph node metastasis and clinical stage(P0.05).The median survival time of patients with positive expression of HER 2/neu was 30.0 months,while the patients with negtive was 50.0 months.The difference was significant(P0.05).Cox multivariate analysis showed that HER 2/neu and clinical stages were independent determinants of overall survival.(Conclusions) Determination of the expression of HER 2/neu in gastric carcinoma tissues might be helpful to determine the prognosis of the patients with gastric carcinoma.

title: Expression and prognostic significance of E Cadherin, EGFR, p53 and HER 2/NEU in Gastric Carcinoma.
abstract: Stomach cancer is the fourth most common cancer worldwide (1) It is a disease with a high death rate ~700,000 per year) making it the second most common cause of cancer death worldwide after lung cancer(2) It is more common in men than in women with a ratio of 1.6:1(1, 3) It is a disease of middle aged and elderly with a peak incidence at around 65 years (1) Although a steady decline in the incidence of gastric carcinoma has been noted worldwide, the absolute number of new cases per year is increasing mainly because of the aging population. Decline in incidence rate is seen in the western countries (4) In Asia it is still one of the most common malignancies accounting for 18% of all malignancies. In countries like Japan and Korea it accounts for 56% of malignancies (5) More than 50% of cases present in advanced unresectable stages making cure impossible. The overall 5 year survival rate is 28% irrespective of the stage at which the patient presents. The morphological and histological types of gastric carcinomas are variable and they may not correlate well with the prognosis. The prognosis is mainly dependant on the clinical stage of the disease. But even within a specific stage, there is variability in prognosis from patient to patient. There has been a constant search for specific biological markers to identify the subgroups of patients with more aggressive course of the disease (6) E Cadherin, EGFR, p53 and HER 2/Neu have been proposed as potential tool for the evaluation of prognosis of gastric cancer. E Cadherin plays a crucial role in cell cell adhesion in epithelial tissues. The decreased E Cadherin expression correlates with dedifferentiation, infiltrative tumour growth, distant metastasis, and poor survival for patients with certain carcinomas.  is a transmembrane tyrosine kinase receptor, and is one of the members of EGFR family of receptors. This receptor activation causes stimulation of the downstream signaling pathway that regulates cell proliferation, migration, adhesion, differentiation and survival. Gene amplification and or protein over expression of EGFR have been observed in a variety of solid tumours. p53 is a tumour suppressor gene which negatively regulates cell cycle. A loss of function mutation in p53 gene results in enhanced proliferative activity and tumour progression. In contrast to the normal p53 protein, the mutated p53 protein has an increased half life and hence accumulates within the cell nucleus. This can be detected immunohistochemically using monoclonal antibodies.  The incidence of gastric carcinoma in the year 2011 in RGGGH was 3.26% Many patients were older than 55 years of age with male preponderance which is similar to several other studies conducted throughout the world. Females showed a younger mean age of incidence compared to males. 29% of cases showed reduced expression of E Cadherin. A significant association was found between reduced expression of E Cadherin and reduced survival. A significant association of EGFR over expression was found with moderately differentiated grade. No significant association was found between EGFR expression and survival. An increased frequency of cases with p53 positivity showed intestinal type of Lauren's classification, moderately and poorly differentiated grades and no association between p53 positivity and survival was found. All the cases which showed HER 2/Neu over expression showed T3 level of infiltration, no association with HER 2/Neu expression and survival was found. To conclude, identifying the expression of E Cadherin, EGFR, P53 and HER 2/Neu in gastric carcinoma can help to identify patients with reduced survival and to identify eligible candidates for targeted therapy. A larger sample size and follow up for a longer period might shed more light on the role of the above markers in gastric carcinoma.

title: Expression of pRb, Ki67 and HER 2/neu in gastric carcinomas: Relation to different histopathological grades and stages.
abstract: Gastric carcinoma is one of the aggressive malignancies with poor prognosis. The expression of pRb, Ki67, Her 2 in relation to tumor grade and stage in gastric carcinoma still needs more exploration. This study was performed aiming to study the immunohistochemical expression of altered retinoblastoma encoding protein (pRb) Ki67 and Her 2 in gastric carcinoma and to investigate their clinical and pathological significance. We studied tumor tissue specimens from 48 patients with gastric carcinoma. Paraffin sections were submitted for immunohistochemistry using pRb, Ki67 and Her 2. Statistical analysis was performed for clinical and pathological data of all studied cases. Altered pRb was expressed in 79% of the studied tumors, inversely correlated with tumor invasion and stage with no significant relation with tumor grade, age, and gender and tumor size. Ki67 LI was significantly associated with tumor grade and stage but not related to sex, age, tumor size, site, depth of invasion and lymph node metastasis. Her2 was expressed in 75% of studies tumors with significant association with tumor grade, the depth of invasion, lymph node metastasis and higher tumor stage. However, there was no significant association between Her 2 expression and gender, tumor site and size. In conclusion, altered pRb is frequently expressed in gastric carcinoma, inversely correlates with tumor invasion and tumor stage suggesting an early event in gastric carcinogenesis. Ki67 expression in gastric carcinoma is directly correlated with the tumor grade and depth of invasion. Her2 expression is significantly correlated with tumor grade, depth of invasion and stage.

title: Expression and its correlation of Cox 2 and Her 2/neu in gastric carcinoma tissues
abstract: To study the correlation of cyclooxygenase 2(Cox 2) and Her 2 /neu in gastric carcinoma and their relationship with clinicopathologic features. The expression of Cox 2 and Her 2 /neu in 419 cases of gastric carcinoma was detected by immuno histochemical technique.The results were analysed by SPSS 13.0.Results In 419 cases of gastric carcinoma the positive rate of Cox 2 was 66.35%(278 /419).No correlation was found between increased Cox 2 and the tumor size,differentiation,lymph node metasta sis,clinical stage,distant metastasis and depth of invasion of gastric carcinoma(P 0.05).The positive rate of Her 2 /neu was 13.6%(57/419).Her 2/neu expression was correlated with differentiation(P 0.05).No correlation was found between increased Her 2/ neu and the tumor size,lymph node metastasis,clinical stage,distant metastasis and depth of invasion of gastric carcinoma(P 0.05).The expression of Her 2 /neu was significantly correlated with Cox 2(P 0.025).Conclusion Her 2 /neu expression was correlated with high and middle diferentiation in gastric carcinoma.Cox 2 expression is obviously high in gastric carcinoma which Her 2 /neu expres sion is positive.The overexpression of Cox 2 and Her 2 /neu in gastric carcinoma is closely correlated.

title: Histopathological Analysis and Study on Expression of HER2 and Ki 67 in Gastric Carcinomas
abstract: Carcinoma of stomach is one of the leading causes of cancer deaths in the world. Paucity of the clinical symptoms, delays early detection of this killer disease. Hence resulting in a majority of patients presenting in an advanced or inoperable stage of the disease. In this era of medicine where targeted molecular therapy is gaining importance two markers in relation to gastric carcinoma are analysed. One such marker is HER2 neu. Many studies had predicted amplification of this protein in gastric carcinoma. The other marker is Ki 67. According to various studies Ki 67 reflects the cell proliferation characteristics that reflect the aggressive behavior of tumour. In this study the histopathological characters and relationship between tumour grading and expression of HER2 and Ki 67 were analysed.  This study was carried out in the Department of Pathology, Thanjavur Medical College from the Period of July 2012 June 2014. A total of 140 cases of Gastric carcinoma were analysed. This included 90 endoscopic biopsies and 50 gastrectomy specimens. The Co relation with age, sex, anatomical location, histological type, grading, extent of tumour invasion and nodal status were analysed. Immunohistochemistry was used to analyse the amplification of HER2 and degree of Ki 67 expression. Co relation between the grades of differentiation, HER2 amplification and Ki 67 proliferation index were studied.  The incidence of gastric carcinoma as estimated in this study is 6.78/1000 cases. The most commonly affected age group is 50 60 years. Males are more commonly affected than females. Frank malignancy was detected in 45.6% of endoscopic biopsies in male and 40 of cases in females. The most common site of malignancy is the gastric antrum, localizing nearly 605 of cases. 83.57% of the cases were tubular adenocarcinomas. Lauren's intestinal type of tumours constituted 89.28% of cases with most of the carcinomas invading the muscular layer at the time of surgery. HER2 positivity was seen in 8% of the cases subjected to immunohistochemistry. HER2 expression was more in Intestinal type of carcinomas. Out of 25 cases analysed for Ki 67 labeling index, 52% of the cases had low Ki67 index and 48% of the Cases had a high Ki 67 index. No significant co relation was observed between the grading, HER 2 amplification and the proliferation index.  In this study it was concluded that the percentage of HER 2 amplification in Gastric Carcinomas is 8% There was no significant co relation observed between the degree of HER2 amplification and Ki 67 expression with the tumour grade.

title: Expression and clinical significance of Her 2/neu and NF kBp65 in gastric carcinoma
abstract: The expression and clinical significance of Her 2/neu and NF kBp65 in gastric carcinoma tissue is investigated.The expressions of Her 2/neu and NF kBp65 were tested by PV 9000 immunohistochemical technique in 80 cases of gastric cancer and 30 cases of adjacent normal tissue,the relationship between their expression and clinicopathological features of gastric carcinoma was analyzed.The positive rates of Her 2/neu in gastric carcinoma and adjacent normal tissue were respectively 17.3% and 3.3%(P0.05),over expression of Her 2/neu was significantly correlated with the degree of histodifferentiation and lymphatic metastasis(P0.05).The positive rates of NF kBp65 in gastric carcinoma and adjacent normal tissue were respectively 58.7% and 11.4%(P0.05),expression of NF kBp65 was significantly correlated with degree of histodifferentiation,the depth of invasion and lymphatic metastasis(P0.05).Her 2/neu was positively correlated with NF kBp65 in gastric cancer tissue.High expressions of Her 2/neu and NF kBp65 were significantly correlated with development of gastric carcinogenesis.Combining detection of Her 2/neu and NF kBp65 expression is meaningful to guide molecule targeted therapy and evaluate the prognosis of patients.