Evaluation of prevalence and prognostic significance of human epidermal growth factor receptor 2/neu expression in carcinoma endometrium

Abstract

Context: Endometrial cancer is a frequently encountered gynecological malignancy. An adverse prognostic immunohistochemical marker had not been identified until recently. Recent studies have used human epidermal growth factor receptor 2 (HER2)/neu expression as a marker for adverse outcomes in carcinoma endometrium, as proven in carcinoma breast. Aim: The present study was undertaken to correlate HER2/neu expression with prognostic factors in cases of endometrial carcinoma. Materials and Methods: This was a prospective study on evaluation of HER2/neu expression done on 30 patients with biopsy-proven carcinoma endometrium admitted in the hospital for staging laparotomy. Histopathological examination was performed and HER2/neu expression was assessed by immunohistochemistry and was categorized into (1) Group 1: HER2/neu 0/1+ (negative), (2) Group 2: HER2/neu 2+ (equivocal), and (3) Group 3: HER2/neu 3+ (positive). All the cases were followed up for a period of 1 year. Statistical Analysis: All data analyses were carried out using statistical software SPSS, IBM version 21.0. P< 0.05 was considered as significant. Results: 0/1+ HER2/neu expression (negative) was detected in 19 patients (63.33%), 2+ HER2/neu expression (equivocal) was detected in 4 patients (13.33%), and 3+ HER2/neu expression (positive) was detected in 7 patients (23.33%). HER2/neu 3+ group was significantly associated with non-endometrioid histology (P = 0.003) and high tumor grade (P = 0.005). The association of HER2/neu 3+ group with advanced disease and lymph node involvement showed a trend, but it was not statistically significant. No association was found between HER2/neu overexpression and extent of myometrial invasion. There were two recurrences in 1 year follow-up period. HER2/ neu expression (2+ and 3+) was seen the recurrence cases. Conclusion: HER2/neu overexpression was found to be an adverse prognostic marker in carcinoma endometrium, which could form the basis of targeted chemotherapy.