Annals of Surgical Oncology

, Volume 18, Issue 10, pp 2833–2840 | Cite as

Evaluation of HER2 Protein Expression in Gastric Carcinomas: Comparative Analysis of 1414 Cases of Whole-Tissue Sections and 595 Cases of Tissue Microarrays

  • Kab Choong Kim
  • Young Wha Koh
  • Heung-Moon Chang
  • Tae Hwan Kim
  • Jeong Hwan Yook
  • Byung Sik Kim
  • Se Jin Jang
  • Young Soo Park
Gastrointestinal Oncology



Recent advances in molecular targeted therapy have identified HER2 as an important target for anti-cancer therapy in gastric cancer (GC). Although the clinical relevance and prognostic significance of HER2 in breast cancer has been well acknowledged, it remains controversial in GC.


HER2 expression was investigated in two independent series of GC by immunohistochemical staining. One series corresponded to 1,414 cases of whole-tissue sections and the other corresponded to 595 cases of tissue microarrays (TMAs). Results were compared and correlated with clinicopathologic parameters.


HER2-positivity was detected in 12.3% of whole-tissue sections and 17% of TMAs. Among samples scored 3+, 90.1% stained ≥50% of the tumor area, but only 40.9% in score 2+ cases stained ≥50% of the tumor area. In whole-tissue sections, HER2-positivity was correlated with age (P = 0.002), histological type (differentiated or intestinal, P < 0.001), lymphovascular invasion (P = 0.005), and lymph node metastasis (P = 0.009). In TMAs, HER2-positivity was correlated only with age (P = 0.003) and histological type (P < 0.001). Multivariate analyses of the differentiated GC subgroup revealed that HER2-positivity was an independent poor prognostic factor (P = 0.042). The cases with HER2-positive in ≥50% of the tumor area showed worse prognosis than those of <50% (P = 0.021).


Despite discrepancies in the results from whole-tissue sections and TMAs, HER2 overexpression was positively correlated with aggressive biological behavior and was an independent poor prognostic factor for recurrence in differentiated GCs. Therefore, HER2-positive GCs should be considered for adjuvant trastuzumab therapy.


Gastric Cancer Trastuzumab Lymphovascular Invasion HER2 Expression HER2 Overexpression 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Kab Choong Kim and Young Wha Koh contributed equally to this work. This study was supported by a grant (A081024) of the Korea Healthcare technology R&D Project, Ministry for Health, Welfare & Family Affairs, Republic of Korea.

Supplementary material

10434_2011_1695_MOESM1_ESM.jpg (124 kb)
Supplementary Fig. Kaplan–Meier curves for RFS in relation to HER2-positivity: analyses of all histological types (differentiated and undifferentiated). There were no differences in RFS rate in whole tissue section series (a) and in TMA series (b)


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Copyright information

© Society of Surgical Oncology 2011

Authors and Affiliations

  • Kab Choong Kim
    • 1
  • Young Wha Koh
    • 2
  • Heung-Moon Chang
    • 3
  • Tae Hwan Kim
    • 1
  • Jeong Hwan Yook
    • 1
  • Byung Sik Kim
    • 1
  • Se Jin Jang
    • 2
  • Young Soo Park
    • 2
  1. 1.Department of Surgery, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
  2. 2.Department of Pathology, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
  3. 3.Department of Oncology, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea

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