Estimation of Human Epidermal Growth Factor Receptor 2 (HER2) Expression in Colorectal Adenocarcinoma for HER2 Targeted Therapy
DOI:
https://doi.org/10.52206/jsmc.2024.14.4.868Abstract
Background: Colorectal carcinoma (CRC) ranks among the top cancers globally, with high mortality rates despite treatment advancements. Emerging therapeutic targets, including HER2, well-studied in breast and gastric cancers, are less explored in CRC literature.
Objectives: To determine the frequency of HER2 expression in colorectal adenocarcinoma for HER2-targeted therapy and its association with various clinic-pathological variables.
Materials and Methods: This cross-sectional study was conducted at the Department of Histopathology, Rehman Medical Institute (RMI), Peshawar, from November 15, 2022, to April 30, 2023. A total of 110 cases were included through consecutive sampling. The study included patients of both genders and all age groups who had undergone colectomy (right or left hemicolectomy, extended right hemicolectomy, abdominoperineal resection) and were previously diagnosed with CRC based on colonoscopic biopsies. Colonoscopic biopsy specimens and patients who had undergone neoadjuvant therapy were excluded. Immunohistochemistry assay for HER2 was performed, and the results were interpreted.
Results: The mean age (SD) of study sample was 45 (6.12) years. There was a predominance of male patients. Out of the total 110 patients, HER2 expression was positive in 69 (62.73%) and negative in 41 (37.27%) patients. The lesions were predominantly located in the rectum and left colon in 77 (70.00%) of the patients. Histologically, 92 (83.64%) patients had non-mucinous tumor variants. Among the 69 positive cases, 32 (29.09%) were scored as 1+, 24 (21.82%) as 2+, and 13 (11.82%) as 3+. Tumor grade, tumor stage, HER2 expression, and score were statistically significantly associated with IHC staining intensity (p < 0.001). Similarly, tumor grade, tumor stage, and HER2 score were statistically significantly associated with positivity status (p < 0.001). Furthermore, statistically significant relationship between the degree of differentiation (tumor grade), tumor stage, IHC staining intensity and the score of HER2 overexpression was observed (p < 0.001).
Conclusion: In our study, HER2 expression was observed in a significant number of patients. The findings indicate that HER2 expression correlates with specific tumor characteristics suggesting its potential as a biomarker in management for this disease. Further research with larger sample sizes and broader geographical diversity is recommended to better understand HER2's biological role in cancer.
Keywords: Colorectal adenocarcinoma, Gastrointestinal system, HER2, Immunohistochemistry, Targeted therapy.
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