Abstract
Objectives A cribriform architectural pattern has been reported in 9% of one unselected consecutively collected series of gastric carcinomas (GC) with unfavourable prognostic outcome. Taking into consideration the biological relevance of the human epidermal growth factor receptor 2 (HER2) status, we have analyzed a cohort of GC with a cribriform component more than 40% (CGC) to evaluate the HER2 amplification rate as a potential target for therapy with trastuzumab. Results HER2 overexpression was encountered in 21 of 100 (21%) GC; a progressive increase in HER2 amplification was appreciated moving from non-CGC (20.6%) towards CGC cases (21.6%), although this difference does not reach a statistical significance. Nevertheless, either in univariate or in multivariate analyses, stage and HER2 status showed a significant p value (<0.001) in CGC patients. Conclusions Our data confirmed a worse prognosis in all CGC patients with HER2 amplification, resulting in a shorter survival time. We invite all pathologists in their daily practice to specify the occurrence of cribriform neoplastic component in GC, either in surgical or in bioptical samples, taking into practical assessment the high HER2 overexpression rate in order to correctly treat these patients with worse behavior.
Highlights
The cribriform histological pattern has been attributed to tumors showing an architecture made of straight packed glands with not uniform distributed lumina, without interposed stromal tissue [1, 2]
It has been reported that human epidermal growth factor receptor 2 (HER2) overexpression rate progressively increases moving from the poorly cohesive WHO histotype to the mitochondrion-rich adenocarcinoma (MRC), tubular adenocarcinoma, and hepatoid carcinoma (HAS), which showed the highest frequency of HER2 positivity and the worst prognosis [12]
Taking the clinical course into consideration, 29.5% of 61 patients died for gastric carcinomas (GC) showed HER2 expression/ amplification; only 7.7% showed HER2 overexpression in 39 alive patients; this difference was statistically significant (p = 0 009) (Table 1)
Summary
The cribriform histological pattern has been attributed to tumors showing an architecture made of straight packed glands with not uniform distributed lumina, without interposed stromal tissue [1, 2]. This peculiar pattern has been identified in invasive carcinomas rising in many different organs, such as prostate, breast, lung, colon, thyroid, skin, and stomach [2,3,4,5,6,7]. MUC5AC has been reported as positive, while hormone receptors, CDX2, MUC1, MUC2, and GCDFP-15, were always unexpressed [3]
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