Title: The Expression of HER-2 and Ki-67 in Oesophageal Neoplasms
Authors: Meenakshi Somasundaram, Revathi Ramakrishnan
DOI: https://dx.doi.org/10.18535/jmscr/v5i6.117
Abstract
Introduction: HER 2 is amplified in up to 25% of patients with oesophageal carcinomas. The presence of this amplification provides a valuable novel therapeutic target for this group of patients. In patients with breast cancer who are HER 2 positive, trastuzumab, [a fully humanized monoclonal antibody which directed at HER 2 which binds the external domain of the receptor and exerts its action]reduced recurrence by about 50 percent. So, esophageal cancer recurrence rate is also expected to reduce with this treatment. None of the ligand belonging to the epidermal growth factor family activates HER 2.
Expression of Ki67 is also an independent prognostic factor.Ki67 are found only in actively proliferating cells. Tumors with deeper invasion and an advance stage showed an overexpression of Ki-67 than those tumors that had a superficial invasion and an early stage. Both HER2 and Ki67 expression is done in this study. This study is to evaluate the expression of HER-2 and KI-67 in oesophageal neoplasms and to analyze the value of expression of HER-2 and Ki-67 in determining the prognosis.
Materials and Methods: This is a prospective study undertaken during the period from August 2013 to August 2015. Both the surgical specimens and biopsy material were processed and histopathological diagnosis was made
All the resected specimens were fixed in 10% formalin for 24-48 hours. The immunohistochemical detection of biochemical markers was conducted using monoclonal primary antibody (anti-HER and MIB 1) against HER 2 cytoplasmic antigen and KI-67 nuclear antigen respectively. The super sensitive TM polymer-HRP detection system using biotin polymeric technology was used. In this technique, secondary antibody conjugated to poly-HRP reagent and bound to the primary antibody, is visualized by the DAB. HER 2 and KI67 expressions were interpreted as 0, 1+, 2+ ,3+ ,4+.
Observation and Results: This study is a retrospective one which includes 150 oesophageal biopsies and specimens sent from the medical, surgical and surgical gastroenterology departments , during the period of August 2013 to August 2015.
Out of the 150 samples, 113 were biopsies and 37 were surgical specimens. Of that10 were negative for malignancy on histopathological examination. The rest of 140 samples were taken for study.In total number of cases of squamous cell carcinomas, 12.5% of the cases are positive for HER2, 25% show equivocal results with HER2 and 62.5% of the cases are negative for HER2In total number of cases of esophageal adenocarcinoma, 38.46% of cases are positive for HER 2, 30.76% of cases are equivocal, 30.76% of cases are negative for HER 2 .
In our study, squamous cell carcinomas (Grade 1-16.66%, Grade 2-66.66%, Grade3-16.66%%) cases with >30% Ki67 expression was seen in 33.33% of cases and they were Grade 2 tumors. In adenocarcinoma (Grade3-75%, Grade 2-25%%), >30% Ki67expression was seen in % of cases and they were grade 3 tumors.
Conclussion: Ki 67 expression proves to be an independent prognostic factor. There is no correlation between the expression of HER2 and Ki 67 expression
Key Words: HER2, Ki 67, oesophageal carcinomas.
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