Diagnostic Pathology: Open Access
Open Access

Abstract

Her-2 (ErbB-2) is an oncogene frequently overexpressed in breast and gastric adenocarcinomas and anti Her-2 targeted therapy can be given to such patients. Her-2 overexpression and role of anti Her-2 targeted therapy in cases of gallbladder adenocarcinomas (GBAC) is still debatable. Scoring protocols for Her-2 expression in breast and gastric carcinomas are standardized, however not for carcinomas arising in other body organs like gallbladder. This study is conducted to evaluate expression of Her-2 in patients with GBAC which may benefit from targeted therapy. It is a cross-sectional study conducted on patients with GBAC (n=43; 34 women and 9 men). An automated immunohistochemical technique was used with an anti-ErbB2 antibody. Scoring was conducted according to the CAP (College of American Pathologists) criteria for breast cancer, as well as for gastric and gastroesophageal junction carcinomas. When the scoring protocol for breast carcinomas was used, positive Her-2 staining was observed in 11/43 (25.6%). Out of 11 positive cases, 5 cases (11.6%) were unequivocally positive (3+) and 6 (13.9%) showed equivocal staining. According to the gastric and gastroesophageal junction carcinomas protocol, positive Her-2 staining was observed in 16/43 (37.2%). Out of 16 positive cases, 11 (25.5%) were unequivocally positive (3+) and 5 (11.6%) showed equivocal staining. This study indicates that significant number of GBAC cases show Her-2 overexpression when either of the two documented protocols is used. This subgroup may benefit from inhibitors of the Her-2 pathway. Standardization of scoring protocol for Her-2 expression in GBAC is needed to better evaluate predictive potential of Her-2 for treatment of these tumors.

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