| ObjectiveThe study aims to evaluate the HER2 expression in early and advanced gastric cancer.To explore the correlation of HER2 status with the risk of early lymph node metastasis and other clinicalpathologic features.Thus to reveal the role of HER2 in predicting the risk of early lymph node metastasis and the necessity of HER2 detection.To provide clinical reference for the choice of treatments or the evaluation afther endoscopic resection in early gastric cancer.In addition,the specific clinicopathological parameters of patients whose HER2 is overexpressed are selected to increase emphasis on HER2 detection,improving the detection rate of HER2 in gastric cancer,providing an effective treatment approach for patients with HER2 overexpression in gastric cancer.MethodsThe clinicopathological data of patients undergoing radical gastrectomy and HER2 detection for gastric cancer in the First Affiliated Hospital of Anhui Medical University from January 2014 to June 2021 were retrospectively collected.Clinicopathological data of patients with early and advanced gastric cancer jointly confirmed by 2 pathologists in our hospital were included,including general information（gender,age of onset）,HER2 status,tumor site,invasion depth,longest diameter of the tumor,grossly type,differentiation degree,presence or absence of vascular invasion,and lymph node metastasis.The difference of HER2 expression in early gastric cancer and advanced gastric cancer was compared.Patients with early gastric cancer were divided into two groups according to lymph node metastasis,and the differences of the above data were compared between the two groups.Univariate and multivariate logistic regression models were used to evaluate the risk factors of lymph node metastasis in early gastric cancer.The risk prediction model of lymph node metastasis in early gastric cancer with and without HER2 status was established,according to the ROC curve of subjects,AUC is compared to evaluate the prediction efficiency.Patients with early and advanced gastric cancer were divided into two groups according to their HER2 status.The differences of the above data were compared and the correlation between HER2 status and clinicopathological features was analyzed.ResultsA total of 1151 patients with gastric cancer who had undergone HER2 detection were included,with the overall HER2 IHC（3+）ratio was 9.5%,and there was no significant difference between early gastric cancer and advanced gastric cancer（P>0.05）.A total of 157 patients with early gastric cancer were included,of which 31 were positive for lymph node metastasis,with a rate of 19.7%.Univariate analysis showed that gender of patients,HER2 status,invasion depth,differentiation degree and presence of vascular invasion were correlated with lymph node metastasis（P<0.05）.Multivariate analysis showed that HER2 status,invasion depth,differentiation degree and presence of vascular invasion were independent risk factors for lymph node metastasis（P<0.05）.In ROC comparison of risk prediction models,the AUC included HER2 status was 0.802,its truncation value was 0.235,sensitivity was 71.0%,specificity was 78.6%,The AUC without HER2 status was 0.767,its truncation value was 0.226,sensitivity was 64.5%,specificity was 79.4%.The risk prediction model included HER2 status may have good predictive efficiency.The differentiation degree was correlated with HER2 status（P<0.05）.A total of 994 patients with advanced gastric cancer were included,and the results showed that the Borrmann type and differentiation degree were correlated with HER2 status（P<0.05）.ConclusionsThe expression rate of HER2 in gastric cancer patients is low.HER2 IHC（3+）,infiltrating into submucosa,poor degree of differentiation,vascular invasion were independent risk factors of lymph node metastasis in early gastric cancer.The new established model including HER2 status has good sensitivity and specificity,HER2 status has good predictive value for the risk of lymph node metastasis in early gastric cancer.In summary,the overexpression rate of HER2 was high in differentiated early gastric cancer and differentiated,Borrmann 1 type advanced gastric cancer. |
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