Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 21, 2016; 22(23): 5406-5414
Published online Jun 21, 2016. doi: 10.3748/wjg.v22.i23.5406
Association of HER2 status with prognosis in gastric cancer patients undergoing R0 resection: A large-scale multicenter study in China
Guo-Shuang Shen, Jiu-Da Zhao, Jun-Hui Zhao, Xin-Fu Ma, Feng Du, Jie Kan, Fa-Xiang Ji, Fei Ma, Fang-Chao Zheng, Zi-Yi Wang, Bing-He Xu
Guo-Shuang Shen, Jiu-Da Zhao, Jun-Hui Zhao, Xin-Fu Ma, Fa-Xiang Ji, Fang-Chao Zheng, Zi-Yi Wang, Affiliated Hospital of Qinghai University, High Altitude Medical Research Center, Xining 810001, Qinghai Province, China
Jiu-Da Zhao, Feng Du, Fei Ma, Bing-He Xu, Department of Medical Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Jie Kan, People’s Hospital of Qinghai Province, Xining 810007, Qinghai Province, China
Author contributions: Shen GS and Zhao JD contributed equally to this work; Shen GS, Zhao JD and Xu BH designed the research; Zhao JH, Ma XF, Du F, Kan J, Ji FX, Zheng FC and Wang ZY performed the research; Kan J and Ji FX contributed new reagents/analytic tools; Shen GS and Zhao JD analyzed the data and wrote the paper.
Supported by National Natural Science Foundation of China, No. 81360318; and the Application and Basic Research Program of Qinghai Province of China, No. 2014-Z-745.
Institutional review board statement: The study was reviewed and approved by the Qinghai University Affiliated Hospital and National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical Colleg Institutional Review Board.
Informed consent statement: Informed consent was obtained from all individual participants for whom identifying is included in this article prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: Technical appendix, statistical code, and dataset available from the coauthor at guoshuangshen@126.com. Participants gave informed consent for data sharing.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Bing-He Xu, MD, Department of Medical Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China. bhxu@hotmail.com
Telephone: +86-10-87788826 Fax: +86-10-8771 5711
Received: January 10, 2016
Peer-review started: January 22, 2016
First decision: February 14, 2016
Revised: May 11, 2016
Accepted: May 21, 2016
Article in press: May 23, 2016
Published online: June 21, 2016
Processing time: 144 Days and 19.5 Hours
Abstract

AIM: To determine whether the positive status of human epidermal growth receptor 2 (HER2) can be regarded as an effective prognostic factor for patients with gastric cancer (GC) undergoing R0 resection.

METHODS: A total of 1562 GC patients treated by R0 resection were recruited. HER2 status was evaluated in surgically resected samples of all the patients using immunohistochemical (IHC) staining. Correlations between HER2 status and clinicopathological characteristics were retrospective analyzed. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard model, stratified by age, gender, tumor location and tumor-node-metastasis (TNM) stage, with additional adjustment for potential prognostic factors.

RESULTS: Among 1562 patients, 548 (positive rate = 35.08%, 95%CI: 32.72%-37.45%) were HER2 positive. Positive status of HER2 was significantly correlated with gender (P = 0.004), minority (P < 0.001), tumor location (P = 0.001), pathological grade (P < 0.001), TNM stage (P < 0.001) and adjuvant radiotherapy (74.67% vs 23.53%, P = 0.011). No significant associations were observed between HER2 status and disease free survival (HR = 0.19, 95%CI: 0.96-1.46, P = 0.105) or overall survival (HR = 1.19, 95%CI: 0.96-1.48, P = 0.118) using multivariate analysis, although stratified analyses showed marginally statistically significant associations both in disease free survival and overall survival, especially among patients aged < 60 years or with early TNM stages (I and II). Categorical age, TNM stage, neural invasion, and adjuvant chemotherapy were, as expected, independent prognostic factors for both disease free survival and overall survival.

CONCLUSION: The positive status of HER2 based on IHC staining was not related to the survival in patients with GC among the Chinese population.

Keywords: Human epidermal growth receptor 2; Gastric cancer; R0 resection; Chinese population; Prognostic factors

Core tip: The study retrospectively analyzed the associations between the positive status of human epidermal growth receptor (HER) 2 and survival of patients with gastric cancer (GC) undergoing R0 resection among the Chinese population, and found that the positive status of HER2 based on immunohistochemical staining was not related to survival in GC patients.