Objective: To assess immunohistochemistry for HER2/neu expression in preneoplastic and neoplastic lesions of uterine cervix and its correlation with histological type, grade and stage.

Methods: Total 50 cases was included during a period from 2017 to 2018. It was a cross-sectional study including both preneoplastic and neoplastic lesion of uterine cervix, immunohistochemistry for HER 2/neu expression was performed in all the cases.

Results: HER2/neuexpression was seen in 56% cases. Out of 50 cases, 10 was preneoplastic (CIN) and 40 was neoplastic (SCC and adenocarcinoma) lesion. HER2 /neu expression was seen in 3 cases of CIN III, 20 cases of SCC and 5 cases of Adenocarcinoma. Among 35 cases of squamous cell carcinoma, 6 cases were negative for HER2/neu(17%), 9 cases scored 1+(25%), 14 cases 2+(40%) and 6 cases were 3+ (17%). HER2/neu expression was about 50 % in well differentiated SCC, 50% in moderately differentiated and 86 % in poorly differentiated type. Out of 5 cases of adenocarcinoma, HER 2/neu expression was seen in all the cases, of which 3 cases (60%) showed 1+positivity and 2 cases (40%) showed 2+ positivity. 9 cases showed lymph node metastasis positive and out of which 7cases showed HER2/neu positivity (77.77%) and all of them belonged to SCC. Among 14 cases of parametrial extension, 9 cases were positive for HER2 /neu marker. Out of 9 cases 7 cases were of moderately squamous cell carcinoma, 1 was of poorly differentiated SCC and 1 cases of  adenocarcinoma.

Conclusion: This study shows HER 2/neu expression in cervical carcinoma correlates with higher clinical stage. HER 2/ neu expression correlates with lymph node metastasis and with parametrial extensions.

Keywords: Uterine cervix, preneoplastic and neoplastic lesions, Immunohistochemistry, HER 2/neu.

1. World Health Organization, Comprehensive Cervical Cancer Control:A Guide to Essential Practice, WHO, Geneva, Switzerland, 2006.
2. Sankaranarayanan R, Ferlay J. Worldwide burden of gynaecological cancer: The size of the problem. Best Pract Res ClinObstetGynaecol. 2006;20:207–25
3. Kumaran JR. Blaustein’s Pathology of female genital tract, 5^th New Delhi: Springer(India) pvt ltd; 2002; 253-324
4. Tavassoli AF, Deville P.WHO classification of tumors,Pathology and genetics-Tumors of the breast and female genital ograns.Lyon, France: IARC press;2003: 259-290
5. VaidyanathanK , Kumar P, Reddy CO et al. ErbB-2expression and its association with other biological parameters of breast cancer among Indian women. Indian J Canc. 2010;47(1):8-1
6. Reyes HD, Thiel KW, Carlson MJ, Meng X, Yang S, Stephan J, et al. Comprehensive profiling of EGFR/HER receptors for personalized treatment of gynecologiccancers. Mol Diagn Ther. 2014;18(2):137-51.
7. Gupta N, Singh S, Marwah N, Kumar S, Chabra S, Sen R. HER-2/neu expression in lesions of uterine cervix: Is it reliable and consistent? Indian J PatholMicrobiol.2009; 52:482-485.
8. Sharma N, Kaushik A, Sumanashree, Sharma U. Evaluation of H[12]er-2 neu Over Expression in Morphological Variants of Cervical Carcinoma: A Study of 25 Cases. AABS. 2016;3(2):A207-A213
9. Sarwade P, Patil S, Bindu R. Immunohistochemistry study for HER-2/neu expression in lesions of uterine cervix. Int J Cur Res Rev 2016; 8 (13).
10. Carreras R, Alameda F, Mancebo G, García- Moreno P, Mariñoso MLM, Costa C, et al. A study of Ki-67, c-erbB2 and cyclin D-1 expression in CIN-I, CIN-III and squamous cell carcinoma of the cervix.Histopathol. 2007;22:587-92.
11. Li G, Yu D, Zhong-Qiu W. Significance of EGFR, HER-2 and VEGF expressions in cervical intraepithelial neoplasia and squamous cell carcinoma. Cancer Res Clin.2013; 25(11): 750-753.
12. Lakshmi S, Nair MB, Jayaprakash PG, Rajalekshmy TN, Nair MK, Pillai MR. c-erbB-2 oncoprotein and epidermal growth factor receptor in cervical lesions. Pathobiology.1997; 65:163–168.
13. Joseph T and Raghuveer C.V. HER-2/neu expression in cervical intraepithelial neoplasia and cervical carcinoma.IJBAR 2015; 6 (1).
14. Costa MJ, Walls J, Trelford JD.c-erbB-2oncoprotein over-expression in uterine cervix carcinoma with glandular differentiation. A frequent event but not an independent prognostic marker because it occurs late in the disease.Am J ClinPathol.1995; 104: 634–642
15. Ndubisi B, Sanz S, Lu L, Podczaski E, Benrubi G, Masood S. The prognostic value of HER-2/neu oncogene in cervical cancer. Ann Clin Lab Sci. 1997;27(6):396-401
16. Kihana T, Tsuda H, TeshimaS,Nomoto K, Tsugane S, Sonoda T, et al. Prognostic significance of the overexpression of c-erbB-2 protein in adenocarcinoma of the uterine cervix. Cancer. 1994;73:148-53.
17. Hale R J,Buckley C H, Fox H, Williams J. Prognostic value of c-erbB-2 in expression of Uterine Cervical Carcinoma. J ClinPathol.1992; 45: 594-596.
18. Brumm C, Riviere A, Wilckens C: Immunohistochemical investigation and northern blot analysis of c-erb B2 expression in normal, premalignant and malignant tissue of cervix uteri. Virchowarcheivepathol Anat. 417:477-484,1990.
19. Mandai M, Konishi I, Koshiyama M, Komatsu T, Yamamoto S, Nanbu K, et al. Altered expression of nm23-H1 and c-erb B-2 proteins have prognostic significance in adenocarcinoma but not in squamous cell carcinoma of the uterine cervix. Cancer. 1995;75:2523-9.
20. Yong H, Shumo C, Shaoyin Y, Daren S. Expression of c-erbB-2 and PCNA in cervical adenocarcinoma and its signification. Chin J Canc Res. 1998; 10(1): 68-70.

Dr Vijai Singh

Associate Professor, Department of Pathology, Hind Institute of Medical Sciences Barabanki, Uttar Pradesh

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.